HomeMy WebLinkAboutXochitl Gonzalez/The CLIO
RECEIVED
City of Miami Beach Office of the City Clerk 1
1700 Convention Center Drive, Miami Beach, Fbl31j~ N - 1 PH 3: 2
Email: dtyderk@cLmiami-beach.f1.us U't'
LOBBYIST REGISTRATION FORMC\1Y ClJ.HK'S Off ICE
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
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CJ Check Box if an Amendment
(M.I) DATE QUAUFIED AS LOBBYIST
NAM E OF LOBBYIST:
BUSINESS ADDRESS:
IQ)03
(Zip Code)
212,0~ '3. J..\.~PICf-. ~22
TELEPHONE NUMBER:
ll7..~8'3 ,LI-~lo
FAX NUMBER:
EMAIL:
I. LOBBYIST RETAINED BY:
J\?, r,L1D ~S
NAME OF PRINOPAl./CUENT:
BUSINESS ADDRESS: (Numb r and Street) (City)
212 .ldt;3,~?l5D 212..ld63.4-1q~
TELEPHONE NUMBER: FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (e)]
NAME OF CHIEF OFFICER, PAATNER, OR BENEFICIARY:
. UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
kN3/iINb ON &fllhFDF7Jle &tOJly,JIf1e05 Jl) K.E~/I/e I1JhMl I!EAtw Vf'JJ/(JUJ!I&IYtE,1lANl:
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/TItle
B) Relationship
M I A'Mf Bt;,ACH V (lA-
NOtJe
.Lv. U.L:t\"L.U~UKI: ur ICKPI;:t "AU A....uun1:::11 ur LUDDT1:t1 ,",UMrcn~IIUI" \U.1::K..LU::IC vvnClnCK nUUKl.l,
FLATRATEOR OTHER)~
A) LOBBYIST DISCLOSU~_(7
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): 00
1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2, Article VII. Division 5
Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaian Contributions Bv Lobbvists On Procurement Issues":
2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions Bv Lobbvists On Real Estate Develooment Issues":
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V. SIGNATlJRE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contained in Se . n 2-4 of the . mi Beach City Code as amended, and all
reporting requirements
VI. LOBBYIST IDENTIFICATION: " h
\2:>sc;,pc;,v-. ~..::,.
ISI/'ProducedID \Od~IO~( ()
Form of lcEntification
Personally Known
VII. SIGNATlJRE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me ,Jr
This \ day o(""[x: (::;. ,200f'
~I'\
Jci l l On- (lJoP l~"--
Signature of Public Notary - State of Florida
PAULA CAlDlAON ~l ')\0 Cq~
. CcIlIIMfIlIlIIII.
. . EIopiIw- Print, stamp or type name of Notary Public
~ ....1IIlI
.. l'IoItdI IIlO
FOR CLERK'S USE ONLY
Registration: [--{ACCEPTED [ ] REJECTED DATE: \7,104
If rejected, state reason: ./
Registration fee paid: [~es [ ] No [\}CaSh [ ] Check MCR# -:;;;l ( rw c::cX..o
DATA ENTRY DATE: ~,2003 ENTERED BY: Q-> "
2nd Revision 3/18/03 F: \CLER\HATL\Lobbyists\registrationa03.doc
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