Affidavit 11/16/2000
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci. m ia m i-beach. fl. us
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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
COMMmEE; OR ANY ACTION, DECISION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION-MAKING PROCESS ON SUCH ACTION,
DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A OTY BOARD OR COMMmEE. 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 LOBBYIW IS REQUIRED TO FILE A "CERTIFlCA OF ITHDRAWAL. n
1) Lobbyist Nam v:f~ , , S
~ Last Name First Name Middle Initial
Business Phone~ h 7 3-c5.7:~essage Phone (_).
Business Address: ~()/ ~ 71-, if,
k/~ ~~~ ~
City v , tate
3~~;/
33/9@e
Zip Code
Email Address:
2)
O~ii~E: S l7:.-'V't--le ~ ~er/C!-c;.
If different from abo;t
MIa-- 8c
City
Street
Ct/A/V1 c1 eh f~r
State
Suite
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
. C~. .
3)
'/4
4. Identify e~c~ indivifl~1 (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied. .} . 0/1'''' cI- 9h A ~
c 1 / I ~ /~
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
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: /1;/0/1 e
ON JULY 1 Sf OF EACHYEAlt EACH LOBBYST SHAL,L SUBMIT TD 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' 2-482 of the Miami Beach City Code as
amended, and all reporting r. q rements.
Signature of Lobbyist:
o P{rsonally known
~P~oduced ID
G355-777~ 31.3~L)
Identify
~~ MIItoAFemondez
* ~ *1Iry CommIItIon CC821Z48
"ll.!I"" ExpiNI- 28. 2003
Notary or De ty Cler.
/)1//4/4 If. hlj~/J~? _
If Notary, print, stamp or type as com~issioned
FOR CLERK'S USE ONLY
, 'fi' ~
o Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
" Sworn to and sUbscrib~ =e
This 1!rJ day of v 2000.
.
,
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Registration: [~CCEPTED
[ ] REJECTED DATE:
II!Jft!riJ
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-fur-Profit Organization
[ ] Cash [ ] Check MCR #
II! II/) In. 2000 ENTERED BY: .~
, ."
DATA ENTRY DATE: