Affidavit (Ecotech Products)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(olci. m iam i-beach. fl. us
AFFIDAVIT
LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRlNCIPAL 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, DURlNG THE TIME PERlOD OF THE ENTIRE DECISION-MAKING PROCESS ON SUCH ACTION,
DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMmEE, THE TERM SPECIFICALLY INCLUDES THE PRlNCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTlvrnES
FALL WITHIN THE NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH
PERSON WHO WITHDRAWS AS A LOBBYIST IS REQUIRED TO FILE A "CERTlFICAT OF WITHDRAWAl..
1) Lobbyist Name:
Last Name First Name Middle Initial
Business Phone ~ ~ ! 2- ~ J Lj X {J Message Phone (~
Business Address: l.fLf if g ('{'eke (( Au!'" ~j /+c? (7/- L-f h:J
/}1/~~ {\, )~L Street ~35/3 ( Suite
City , . State Zip Code
Email Address:{...(./cJS@Clf.(AL-./..LJ.C_o.lV(
2) Principal Retained by: ECo+t"c~ frr?J.(~c. +-S TAY
/ 0 /y~? q 0(''?'} 'S~ + Dt/v e S,~./fe 20 (
If different from above Street Suite
Ml?x 41/ FL. "33/) /0
City I State Zip Code
(a) If a corporation, partnership; or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
AN) reS });'A L
.
3) Subject Matter (Describe in Detail):
4. Identify each individual (Commi
to be lobbied:
, Board, Committee, Aut
Ice 16 '
r
c;,
rity member or City, sta
? -
S. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
Q The City Commission on .2001
Q City Commission Subcommittee on ,2001
Q City Staff on .2001
a City Board or Committee on ,2001
Q Personnel on .2001
a Identify Others on ,2001
6. State the extent of any business, financial, familial, professio~1 or other relationship which
exists with any individual identified in number (4) above: ~ A-
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY
CLERK A SIGNED STATEMENT UNDER OATH, USTlNG 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 provisions contained in Section 2-482 of the Miami Beach City Code as
amended, and all reporting requirements.
Signature of Lobbyist:
Q ~nally knOw('1
VProduced 10 ~
~ke an oath, or
a Did not take an oath
l J--'D rll ~ ~~ 5'- Vu~ ~I
Identify
State of Florida, County of Miami-Dade
S_,'J\1!"''"T-i ~
This ~day 0 2001.
n NetaFf or ~
If Notary, print, stamp or type as commissioned
Registration:
[~PTED
FOR CLERK'S USE ONLY
[ ] REJECTED DATE: 1-=.3 r ~ () r
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-tor-Profit Otllalljz~tjolJ.- LI r-
[ ] Cash []Check MCR# <t5> '1 U l
DATA ENTRY DATE:
.2001
ENTERED BY: