Affidavit
,
-
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerklOlci. 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 OTY BOARD OR
COMMmEE; OR ANY ACTION, DEQSION OR RECOMMENDATION OF ANY PERSONNEL DEFINED IN ANY MANNER
IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DECISION'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 COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIvmES
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 "CERTIFICATE OF WITHDRAWAL."
1) Lobbyist Name: ~du~^ ~ 'Sa^,hI4,?o D .
Last Name First Name Middle Initial
$3'--111.;),
J./"E)fD
Suite
3313/
Zip Code
Business Phone ~ $3 {, -t (I ~ Message Phone ~
.;10/ So. 6u)~ hLut:j
No. smtlo
State
Business Address:
_htL~
City
Email Address: ~~d)<-kw~. Corr.
2) Principal Retained by: ~ ~ )(6
~lfq n.c. S'~_-P.L
f different from above Street
<
l";O fbrh,A'nn 6H"~J... f'1J/1h
Suite
3~(37
Zip Code
City
State
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
.. ,
3) Subject Matter (Describe in Detail): -'tfb./tPr.b.. nDVI I" I'll"'''' #{^Wl
~~ ;::: :J~~).~J,40:~~~I~~'/1~'1 '~C~
4.
Identify each incRvidual (Commissianers, Board, Committee, Auth rity membe or City ,staff)
to be lobbied: ~
~ ~tf'\.uI'1A~~J tV~ ((,,/'1,1. ~;, {tf,S.hl't..a {;1orw.... r.o f)t'!:frvrl...PY1
,
~
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:
ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY
CLERK A SIGNED STATEMENT UNDER OATH, UsnNG 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 ~ments. ~
Signature of Lobbyist:? ~
~ Personally known
o Produced ID
:5a.--+.,,Q. en D
" Identify
f (' ..Du> ;"'I...V, oLt q
o Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscrib~ be~?~~ me
This .Jtl u. day of ~ 2001.
~ke~ .!uA~
- Notary rt Deputy Clerk
,~,., Elizabeth Bemardo
;~*MY cammilllon CC768873
..~~"",.-; Expir8IAuguat 12, 2002
If Nota ,print, stamp or type as commissioned
FOR CLERK'S USE ONLY
Registration: [...,(A'CCEPTED [] REJECTED
DATE: /-d-9-0 I
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No [] Not-for.pro~a~tn
[ ] Cash [ ] Check MCR # b.3
DATA ENTRY DATE: . 2001 ENTERED BY: