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Affidavit (05/04/2001) m - CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Cel,ter Drive Miami Beach, FL 33139 cityclerk(Ci)ci. m iam i-I leach. fl. us AFFIDAVIT LOBBYIST MEANS ALL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, BY A PRINOPAL WHO SEEKS TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIACATION OF ANY ORDINANCE, RESOLUTION, ACTION OR DECISION OF ANY COMMiSSIONER; ANY ACTION, DECISION, 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 DEOSION-MAKING PROCESS ON SUCH ACTION, DEOSION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY COMMISSION, OR A em BOARD OR COMMmEE. THE TERM SPEOFICALLY 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." Jeffrey First Name r.essage Phone L..-) Middle Initial Lobbyist Name: Bercaw Last Name Business Phone (uJ.s.) 377-62?0 1) City Email Address: 2) Principal Retained by: Beta Epsilon Cadillac. L.L.C. If different from above State 33131 Zip Code 850 Suite Business Address: 200 S. Biscayne No. Miami Boulevard Street Florida c/p Bercow & Radelli P.A. 200 S. Biscayne Bou evard Street R';O Suite Miami City Florida Sti:lte 11i 11 Zip Code (a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner, beneficiary or interests. Nick Economos 3) Subject Matter (Describe in Detail): Variance Application to be Considp.red by the Board of Adjustment. 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: city staff, Board of Ad;us1I:.ment (at- pnhli... h""rin')) 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 lSl City Board or Committee Board of Adj ustment o Personnel o Identify Others .2000 .2000 .2000 ,2000 .2000 .2000' on on on on May 4 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: Nome';! ON JULY 1sT OF EACH YEAR, EACH LOfJBYST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTING A lOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. Signature of Lobbyist: ~Personally known o Produced ID e true and correct an at I have read or each City Code as , '.. . :~~ . . ''i Identify ;. . I, o Did take an oath, or i Did not take an oath State of Florida, County of Miami-Dade Sworn to and subscribed before me This 3o+e-.. day of ~ 200~. ~.~OCf~ Notary or Depu Cler ..,:..r. , ",.,.V Pt'l~ CRISTINA 0, GONZALEZ ~&'f, COMMISION '" CC 727273 ~ ~ IOXPIRESMAR23,2002 BONDED THRU OF ATLANTIC BONDING CO" INC, If Notary, print, stamp or type as commissioned FOR CLERK'S USE ONLY Registration: ['fJ ACCEPTED [ ] REJECTED DATE: ~ 4- ) ')-OU \ Uu If rejected, state reason: /' Registration fee paid: [0 Yes [ ] No [] Not-for-Profit Organization , C2l. [ ] Cash [.I(Check MeR # :LoS q Ie (;if " ,! " ,.:~ DATA ENTRY DATE: .2000 ENTERED BY: