Affidavit
m
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci. 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, 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 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 A LOBBYIST IS REQUIRED TO FI~CERTIFICATE OF WITHDRA~'
1) Lobbyist Name: .s -S ~ ;)
Last Name First Name Middle Initial
Business Phone (~ 1>~ \- Ca.oc.6
Business Addres~: iG
J\. #1t No.
City
If different from above
ML1:.h\
City
Message Phone (_)
S;u / Sf- s.-bt-
Stre~ I '3. J{ b Suite
State Zip Code
CSL- eUC.\'~ ~
Email Address:
2) Principal Retained by:
col\
~
VI;;;
Suite
?3il'1
Zip Code
(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 Q.etail):
~ ~ l, he>" l..bf ,"""t.e.
4. Identify each individual (Commissioners, Board, Committee, Authority member or Oty staff)
to be lobbied: t i\ ~
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
o City Commission Subcommittee
o City Staff
~ity Board or Committee ~ A~
El Personnel
o Identify Others
.2001
.2001
.2001
,2001
.2001
,2001
on
on
on
on )f 2-
on
on
6. State the extent of any business, financial, familial, professional or other relationship which
exists with any individual identified in number (4) above:
IA /4-
f'-'
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 PREC ING CALENDAR YEAR.
'*-- Did take an oath, or
o Did not take an oath
re true and.correct and that I have read or
482 of the Miami Beach City Code as
I do solemnly swear that all of the forego'
am familiar with the provi~iQns contain
amended, and all repo ng quire
Signature of Lobbyist:. .
'iPersonallY known
o Produced ID
"
I' ""...
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This -.I 11 day of 11 Ae.,,~ . 2001.
.' \
i
,,; ~ Ell;abeth Morale.
';"~*1Iry Commission CC883033
~;~
N or Deputy Clerk
If Notary, print, stamp or type as commissioned
FOR CLERK'S USE ONLY' . . ., . '. .
Registration: ~D [] REJECTED DATE: '3 )2-10 I
l {
If rejected, state reason: .--'
Registration fee paid: lJ-Vl!S [ ] No [] Not-for-P"etjt Or:9a~izjltio..nl'A Q
[ ] Cash [ ] Check MCR # k..;;)~U::+--:1
DATA ENTRY DATE: . 2001 ENTERED BY:
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