Affidavit
m
-
-
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
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
DEOSION OF ANY COMMISSIONER; ANY ACTION, DEOSION, RECOMMENDATION OF ANY OTY 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,
DEOSION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE OTY 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 AS A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL."
1) Lobbyist Name: ./111 t{' A-"fJ9f::::r .lj ()/J tis U-;J C!-
Last Name First Name Middle Initial
Business Phone a.f!n. TCJ 'f--h0G?C) Message Phone (t:/jr I.ri? ~ '2.-f-cJ 7
Business Address: -;'tJV ~ ~0;/d<p 8/-.V'D
rf; Aihfb No. S~4
, . City , State
Email Address:1)r.fk (,;) 12 (J ];:;I?V ~ (' n tit
2) Principal Retained by: ~ ~ a;( # If-( t) F rHf-
Lf 7 () J iJ ' tit nnf) HJ Il-<Y c::
If different from above Street ., () ,
)1;~~{ JjeAe1-f ~
City State
;; Suite
f;>oZ-
Zip Code
:f1-.Jt'
Suite
33J'(-D
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, beneficiary or interests.
Subject Matter (Describe in Detail): ~,~ ':fJ
~
3)
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: II- L-L- ' \
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 1-31 .2001
0 City Commission Subcommittee on ,2001
0 City Staff on / ~ dO ,2001
0 City Board or Committee on /~3D .2001
0 Personnel on .2001
0 Identify Others on ,2001
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above: Yo (J1e-.
,
ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY
CLERK A SIGNED STATEMENT UNDER' OATH, USTING 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- of the Miami Beach City Code as
amended, and all reporting re Irements,
Signature of Lobbyist: ,
~zo p~~o~:~YI~nowYVI {)- 0;2- - ) ~ 3 ~ ~ - Y I ~
Identify
Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
SwornJo ht subscrib before me
This ~ day 0 2001.
,
'~
r~r Deputy Clerk
If Notary, print, stamp or type as commissioned
Registration:
[~D
[ ] REJECTED
FOR CLERK'S USE ONLY
DATE: 1-- "3/-0 I
,
DATA ENTRY DATE: