Affidavit (Victoria's Secret)
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerk@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, DECI~il'N, 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 ENT,RE DECISION-MAKING PROCESS ON SUCH ACTION,
DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION,
OR A CITY BOARD OR COMMmEE. THE TERM SPEClACALL Y 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: Larkin
Last Name .
Business Phone Un..sJ 377 - 6 2 31
Michael
First Name
l.essage Phone L)
w.
Middle Initial
Business Address: 200 S. Bi scayne
No.
Miami
Boulevard
Street
Florida
City
Email Address:
2) Prindpal Retained by:
Victoria's Secret
If different from above
State
33131
Zip Code
850
Suite
Miami Beach
City
901 Lincoln Road
Street
Florida
SMe
Suite
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 Detail): Historic Preservation Board Appltcation
Mnnif;~;:"t-;()n t-n Drior Condit-ionAl n~p Annrnv~l
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: Board. Ci ty Staff
5. The subject matter in number three (3) above is to be considered at the meeting of
(Identify each entity or individual):
March
.2000
,2000
.2000
13,2000
,2000
,2000"
-
Q The City Commission
a City Commission Subcommittee
Q City Staff
~ City Board or Committee Historic
Q Personnel
IJ Identify Others
on
on
on
Preservation Boar~n
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:
ON JULY 1sT OF EACH YEAR, EACH LOBBYST SHALL SUBMIT TO THE CITY CLERK A
SIGNED STATEMENT UNDER OATH, USTlNG A 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
::~:::r: :fn~O:~~:~rting requirements, M _ VV '" ,
.
.:~ ~..
X Personally known
Q Produced 10
. 'I
Identify
,"L'
I.
IJ Did take an oath, or
Q Did not take an oath
,.,..,\:'~ USAC,BROOKS
f.'f~' ',.\ MY COMMISSION # CC S56829 '
'. . . ~ '. : 1 EXPIRES: July 20, 2003 .
State of FlOrida, County of Miami-Dade ~;l;R~:f.<.'" Boo"'dThIUNOI'~PU,"CUO""NO""
Sworn to -ppd subscribed before fT1e. clOD/' ~"
This {j day of ,Mtlvz.,h., 2,980. ~ ^
, Notary or Deputy Clerk'" .',; ,
If Notary, print, stamp or type as commissioned
Registration:
[~CEPTED
FOR CLERK'S USE ONLY / J
[ ] REJECTED DATE..... ~ _ f 0 /
/ I '
If rejected, state reason: /
Registration fee paid: r--tYes [ ] No [] Not-for-Profit Organization
[ ] Cash [ ] Check M:~ #
, ~ '. ':,1
DATA ENTRY DATE:
.2000
ENTERED BY: