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John K. Shubin 2022 Fee Expenditure and Compensation Form • City of Miami Beach Lobbyist Fee Expenditure and Compensation Statement City Code Section:2-485 RECEIVED FEB 25 2022 01/01/21 . 12/31/2021 Expenditure report for the period of: .. through CITY F ' r l BEACH A statement:shall be filed even if there have been no expenditures or compensation during the rq�r TY 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 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 at cityclerk@miamibeachfl:gov. Lobbyist. ' John K Shubin Principal 93 Palm Residence,LLC.(Toni Alam) Issue: Permit Applications for 93 Palm Ave. PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: Hourly Rate CATEGORIES OF EXPENDITURES Food and Beverage: NA Entertainment: NA Research: NA Communication: NA . . . Media Advertising: NA Publications: NA Travel: NA -- In NA Lodging: g: . Special Events: NA CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida; County of Miami-Dade :.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 herein and any attachment hereto are true and correct. Lo ist Signature SIGNATURE AND STAMP OF NOTARY: Produced ID .',---.,e`G•• JASON GREGORY HEDGES _�% �' r`: Notary Public-State of Florida Form of Identification Commission#GG 250894 p Signature lc Notary—State of Florida Personally:known My Comm.Expires Aug 20,2022 I Sworn to and subscribed before me This ,1 day of 2- ,20(1/1/ F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\CMB LFEaCS.doc Rev,01/04/16