Affidavit (05/08/2001)
.-~
J
lQ
-
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerklOlci .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 CITY BOARD OR COMMITTEE; 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 CITY
COMMISSION, OR A CITY 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 ACTIVrnES 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: /A14cA/J..;E' ~€S. f?l/SS€ /1 p.( ~~-1./ I?M,{
Last Name First Name Middle Initial 1/ I .
Business Phone (~ Z7~ It/tO Message Phone (M '7~? ,..f./D
Business Name and Address:. R~ II .M4c:1:E'N-2.iE ~ /}sSo~;4TCS P II. ~M1)
t!-ol{ c.##e I/re zu;; ,AIf.1ktI. fi. ~?/~
No. Street Suite City State Zip Code
Emaii Address: ~M t<M;f ~ M~". ~III/. -;/;;1 ~
2) Principal Retained by: ~ ~~ J-ayjW-e:f ~ .
~. Wi (
If different from abo e Street Suite
City
State
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):
-2.
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to belobbied:~ ~ ~ / ~ uJ;/!r~ &+; .
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
l::f City Board or Committee
o Personnel
o Identify Others
.2001
,2001
2001
..J : 2001
,2001
.2001
on
on
~~~
on
on
6. State the extent of any business, financial, famili I, profes iona or other relationship which exists with any
individual identified in number (4) above:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH
FOR THE PRECEDING CALENDAR YEAR.
Signature of Lobbyist:
o Personally known
o Produced ID
are true correct and that I have read or am familiar
Miam' Beach City Code as amended, and all reporting
~dA>Sec
Identify
o Did take an oath, or
o Did not take an oath
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This 1t2J day of '117; . 2001.
:AI JV.vn1 f~ 4ft ~
D Notary or ~puty erk
o [z'CUI71 e ~ I~; ~
If Notary, print, stamp or type as com issioned
Registration:
~CEPTED
[ ]
FOR CLERK'S USE ONLY ;.1
REJECTED DATE: ,.<;; f.{/ !) I
DATA ENTRY DATE:
2001
ENTERED BY,