Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk@ci.miami-beach.f1.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, 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 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) LobbYistName:_~ Al..vAf2IA-fO D IkO~ fE...
Last Name First Name Middle Initial
Business Phone CU:f. 5"r~ -"( z. =J...<y Message Phone L) 5A~*=-
Business Address: ~f.-' 3. I" & A V, ) S (./1 ~ 'Z-v I
f..{1 ft H No. sm P-tDA ~3/~u';.i
City State Zip Code
Email Address:e.d..iPrCe@.8-(..C-ki~C+.l/.....? - des 1,4 . 11 e f
2) Principal Retained by: -L1 e e c..r C (;v., rI &> (2a It;,., u /
7010 ..>W '18 U-(.
If different from above Street Suite
k I f1 H(
City
Fl..
State
~31 rr-
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief
officer, partner, benefiCiary or interests.
3)
~w
c ~ prpp..a..rry
4, Identify each individual (COmmissioners~ommittee, Authority member or Oty staff)
to be lobbied:
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
o The City Commission
CJ City Commission Subcommittee
CJ City Staff
CJ City Board or Committee !-lIp
o Personnel J I
o Identify Others
on
on
on
onc9-j ~-
on
on
.2001
,2001
,2001
,2001
,2001
,2001
6. State the extent of any business, financial, familial, pr~ 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 SIGN.ED STATEMENT UNDeR OATH,USTING.LOBSYING EXPENDITURES IN
THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR.
I do solemnly~e,!r that all of the foregoi 9 facts are true and corred(and that I have read or
am familiar with the provisions con . ed' ,Sectior') 2-482 ofthe Mia . each City Code as
amended, and all reporting requi e n
Signature of Lobbyist:
o P~onally known C,\ 11, / I - , . ,
~roduce~ ID,. . '.'1.L.JL fT ,+/,,,.,,,,. "r..:. T5'~ _~9 (;'- a. '. ;2j
Identify
o Di,9.-take an oath, or
o---15fd not take an oath
. ,.
, \..
'':)..
State of Florida, County of Miami-Dade
Swor~..t,o l<WdsUbsc~~t.~~e. ~e
This ~day o"r/ 2001.
r~ ~ ~r
o or Deputy Clerk
If Notary, print, stamp or type as commissioned
'~'
Registration: .. . [ f ACCEfflD
FOR CLERK'S USE ONLY 'J '/ . . . . , .
[ j', REJECTED DATE:::2- _ J.3' . () r
I' . I' .
If rejected, state reason: .---
Registration fee paid: ff~sh[~] N~~~r:~ %g~~ti'fl ()
DATA ENTRY DATE:
,2001
ENTERED BY: