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Carla Grimm 2023 Fee Expenditure and Compensation Forms Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 RECEIVED MAR 12023 Expenditure report for period of:1/1/2022 through 12/31/2022 A statement shall be filed even if there have been no expenditures or compensation during the reportin�}�r{o6F MIAMI BEACH OFFICE OF THE CITY CLERK This statement is to be signed,notarized and returned to the City of Miami Beach,City Clerk's Office,1700 Convention Center Drive, Miami Beach,FL 33139 by February 28th.A fined$50.00 per day,per issue,shall be assessed for statements filed after the due date.If you require any assistance;please contact this office at 305.673.7411 or atcitvclerk(camiamibeachfl.eov. Lobf gist Carly Grimm Sunset Aqua 1736,LLC q Land use/permit matters regarding property located at 1736 W 28 St,Miami Beach, FL PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: 0 • CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: Communications: Media Advertising: NONE Publications: Travel: Lodging: Special Events: • - X CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH tate of Florida unty of Miami-Dade he undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed herein and any attachment eto are true and correct. - L y; t gnature ATURE AND STAMP OF NOTARY: oduced ID Form of Identification ,,,�����„ Angela Verseane Signature of Pu otary—State of Florida ;," '"V 43 Sworn to and subscribed before me Comm.:NH 3292 sonally known , Expires:November 3,2026 This g day of F�•20 a3 Noiary Public-Stale of Florida Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 RECEIVED Expenditure report for period of:1/1/2022 through 12/31/2022• MAR 2023 A statement shall be filed even if there have been no expenditures or compensation during the report ,1�'pe r dMIAMI BEAC OFi=1CF n� THE CITy H This statement is to be signed,notarized and returned to the City of Miami Beach,City Clerk's Office, 1700 Convention CenterK Miami Beach,FL 33139 by February 28th.A fine of$50.00 per day,per issue,shall be assessed for statements filed after the due date. If you require any assistance,please contact this office at 305.673.7411 or atcitvclerk@miamibeachfl.gov. Lobbyist Carly Grimm Principal David Salmanson • Issue Assist with notice of violation#US 2019-03-082&DRB approval for 6626 Roxbury Lane • i PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: $C CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: — I Communications: NONE Media Advertising: Publications: Travel: — I Lodging: Special Events: X CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed her in and any attachment hereto are true and correct - I L bb, ' t gnature SIGNATURE AND STAMP OF NOTARY: _Produced ID Form of Identification Signature o - tary-State of Florida dtlitx Angela Verseano Sworn t and subscribed before me ✓Personally known =_°' Comm.:HH 329243 This..day of. 20 a3 V `Expires:November 3,2026 Notary Public- � Slate of Florida H i