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Affidavit H8~ 16 01 09:228 ____________________ p.2 ~. - - CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK 1700 Convention Center Drive Miami Beach, Fl33139 cityclerk(IDci .miami-beach. lI.us AFFIDAVIT LOBBYIST MEANS AlL PERSONS EMPLOYED OR RETAINED, WHETHER PAID OR NOT, By A PRINOPAL WHO SEEKS TO ENCOURAGE THE PASSAGE, DEFEAT OR MODIFICATION OF ANY ORDINANCE, RESOWTION, ACTION OR DEOSION OF my COMMISSIONER; my ACTION, DEOSION, RECOMMENDATION OF my CITY BOARD OR COMMffiEE; OR ANY ACTION, DEOSION OR RECOMMENDATION OF ANY PERSONNEl DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKlNG PROCESS ON SUCH ACTION, DEOSION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE cm COMMISSION. OR A CITY BOARD OR COMMmEE.THE TERM SPEOFlCALL Y INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT, ATTORNEY. OFFICER OR EMPLOyEE OF A PRINOPAl, REGARDLESS OF WHETHER SUCH LOBBYING AC11VmES FALL WITHIN TkE 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: rUff Et./C, Last Name First Name Business Phone (115) {, 14f - /4 ~ 0 l( .z] Message Phone L) II/+f1 P-. Business Name and Address; CbL...IJN'I' ht~ 10 '{O J..lIt/'UJUr ~MJ, """I/MIt1 (J~. J::.L No. Street Suite City' Email Address: F \ I'~SG. @. Anl 2) Principal Retained by; Go <'-0'"') -rJ, ~ :s AMC Middle Initial 3313Y State Zip Code If different from above City Street ..sA M 2' State 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): t.t=H"MJIIT/()1V &- .f1:)/J/f7IN 1f) 111/E. Cd/Jlt/Y ThE.47l!:rrG ------------- p.3 Ma~ 16 01 OB.22a . 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: !I/f/D/ut Pl(ef/!EllV"TIMI B~~/;J CI11 eo.MMtf.fll/J'll S. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or individual): on 7/11 .2001 . on . 2001 on 200 1 on (,//2 7//0: 2001 on . .. . 2001 on . 2001 )( The City Commission a City Commission Subcommittee D City Staff llf City Board or Committee NlfnlelC PIf,EfMVU/fJN D Personnel D Identify Others 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: ntE,4.Tt.I(. TE.CH,y/cl!-L Q"~G/rQft., 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. I do solemnly swear that all of the foregoing farn 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 amended, and all reporting requirements. _ ~ . Signature of ~ - .'. D Personally known '!- Produced ID F lurId"" ~er:) Identify /-1 (q" S c.. a Did take an oath, or D Did not take an oath State of Aorida, County of Miami-Dade Sworn to and subscribed before me This I~~ day of f-f'J . 2001. k-~M:) Lt)~ N~til~ or Deputy Clerk If Notary, print, stamp or type as commissioned FOR ClERK'S USE ONt Y Registration: ~ ACCEPTED [J RElECrEO DATE: If rejected, stale reason: Registration fee paid: ~~[ [J ~o~ J N~:Ofil "';~~~~ li7 DATA ENTRY DATE: .2001 ENTERED BY: