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Affidavit (03/01/2001) Sent by: WSP/Hilliard 305 673 5352 02/26/01 15:41 Job 245 Page 2/3 m CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach. FL 33139 citvclerklOlci.mlami-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 DEOSION OF ANY COMMISSIONER; ANY ACTION, DEOSION, 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 6Y 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 AS A LOBBYIST IS REQUIRED TO FILE A .CERTIFICATE OF WITHDRAWAL." 1) Lobbyist Name: Looez last Name Business Phone L.1...OI1 443-8288 Jorge First Name Middle Initial Message Phone (30~ 786-709-2226 Business Address: '2121 PQ~(,"~ No. nQ T.Qnn ~,uo DJ.t2 Coral Street ' State G.ble~, FL 33134 Suite 111 14-_,__"., Zip Code Cora' G:::ah1Co9 City Email Address: H'T 2) Principal Retained by: The Cornerstone Group o lI..L_ "'''''Ii" .- ::;:; If~fferent frorn above "- Lc. Street Suite ~.,-' ~m ~ ~ ~~ I (ij'If a corporation, partnership, or trust, identify and provide the address for the chief Co:: J officer, partner, beneficiary or interests. fl' >I."",,, r " '-' Uj c::- i~ >.. stuart I" Meyers & Jorqe Lopez ~,-. a .-,..". 3) SUbject Matter (Describe in Detail): "PQ <; _ nn/n1 4. Identify each Individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: Mavor and City Commissioner Sent by: WSP/Hilliard 305 673 5352 02/28/01 15:42 Job 245 Page 3/3 5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): XI The City Commission :gI City Commission Subcommittee Xi City Staff Xl City Board or Committee CJ Personnel o Identify Others on on on on on on .2001 200! _~___."._._..,.".....--1 _,_._,~"._,.",' 2001 _, 2001 .._"._,2001 " ._,J 2001 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above:, Non"'."".".,.,_..._., ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CrTY 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 foregoing facts are true and correct and that I have read or am familiar with the provisions co taine in Section 2-482 of the Miami Beach City Code as amended, and all reporting req i men . Signature of Lobbyist: JQX Personally known CJ Produced ID Identify ~x Did take an oath, or :J Oi d not take an oath State of Florida, County of Miami-Dade Sworn to and subscribed before me This ..l<6~ day of't...br~..."'Y , 2001. Nota If Notary, print, sta Registration: [ ] REJECTED FOR CLERK'S USE ONLY DATh3 f I / 0 I I I If rejected, state reason: ,/'" Registration fee paid: [ ~es [ ] N9...--f ] Not-for-Profit Organization [ ] Cash [""f'Check MCR # , l. DATA ENTRY DATE: .2001 ENTERED BY: _____"..._.___'''.._......._...1