Affidavit 12/27/2000
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci. miami-beach. f1.us
AFFIDAVIT
Suite
City
State
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
3) Subject atter (Describe in Detail):
4. Identify each indiVidual~mmissioners, oard ommittee
to be lobbied: M fiuL
4//1 t/ dA4ti _ _ ~ F _
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5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual): ~ l3e- d~ C/)ICt{?
0 The City Commission on .2000
0 City Commission Subcommittee on ,2000
0 City Staff on ,2000
0 City Board or Committee on ,2000
0 Personnel on .2000
0 Identify Others on .2000
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above: Ai'"b1 Q..
ON JULY 1 Sf OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEM~:r UNDER OATH, USTING A 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 provision contained in Se ion 2-482 'Of the Miami Beach City Code as
amended, and all reporting r q r mentsr//J/1 ~
Signature of Lobbyist: "1" 4 ,
o Personally known
~ Produced ID
0''35'5 -11'1-:31-3t4-6
Identify
o Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and sUbscrib~ before me
This cJ.-=1- day of I '-Ig~ 2000.
~~
Notary or epu Clerk
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY
/;;.)if:r(1JO
Registration: [~ACCEPTED
[ ] REJECTED DATE:
If rejected, state reason: /
Registration fee paid: [b1' Yes [ ] No [] Not-for-Profit Organization ,1_
[ ] Cash [ ] Check MCR # ~ ;;3 '5 'IQ-:1
DATA ENTRY DATE: 1;"'/ p2-::r- .2000 ENTERED BY: ~ ~