Affidavit 10/04/2000
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CITY OF MIAMI BEACH
OFFICE OFTHE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci .miami-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINCIPAL WHO SEEKS
TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOLUTION, ACTION OR
DECISION OF ANY COMMISSIONER; ANY ACTION, DECISION, RECOMMENDATION OF ANY CITY BOARD OR
COMMffiEE; OR ANY ACTION, DECISION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKlNG PROCESS ON SUCH ACTION,
DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE OTY COMMISSION,
OR A CITY BOARD OR COMMffiEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIVITIES
FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH
PERSON WHO WITHDRAWS AS BB ST IS REQUIRED TO FILE A "CERTIFICATE OF WITHD WAL."
1) Lobbyist Namfi> Q - , 4.
~, L.: st Name First Name Middle Initial
Business Phone ~ h 7'3' S/7 A1essage Phone L)
r tJ/~ (
Suite
Email Address:
2)
€..JL.
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)
'-?ybje~ J><Iatter (Describe in Detail):
{-rOr/ ~'-vl/~ 'ee-r-~7
t."ok I ~)t, f/
/
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: . ~ .
,
5. The subject matter in number three (3) above is to be considered a~~etin~. _
(Identify each entity or individual): i-o (10 Ate /'- ~
A/l"he City Commission
o C!tY Commission Subcommittee
~ity Staff
o City Board or Committee
o Personnel
o Identify Others
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on
on
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6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above:
ON JULY 1 Sf OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEM~ UNDER OATH, USTING A LOBBYING EXPENDITURES IN THE
CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly swear that alTito th foregoing facts
am familiar with the provisio s ~ined in Se .
amended, and all reporting e i .
Signature of Lobbyist:
true and correct and that I have read or
-482 of the Miami Beach City as
o Personally know
it.--Pr'Oduced ID
~Did take an oath, or
o Did not take an oath
3s-S- -777- 3
Identify
State of Florida, County of Miami-Dade
Sworn to )2! sUbscribed~or~e
This -+-day of V 2000.
(
"
8J~~~:rk
If Notary, print, stamp or type as commissioned
Registration:
FOR CLERK'S USE ONLY J
[ ] REJECTED DATE: 10) t I aD
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] NO..J: ] Not-fOr~g~r~
[ ] Cash ~eck MCR
DATA ENTRY DATE:
.2000
ENTERED BY: