Affidavit
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
citvclerk(il)ci .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 CI1Y BOARD OR COMMITTEE; 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, DECISION OR RECOMMENDATION THAT FORESEEABL Y WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPEOFICALLY INCLUDES THE PRINCIPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINOPAL, 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: JO\",es ReIM.!Jo
Last Name First Name Middle Initial
Business Phone (3DSj n ~ - q 2/ 6 Message Phone (~0S) 3:2.2. - S1 s t
Business Name and Address: BOY'jes"t t155oc..\tA.te.5 / P.I.
Y-v.'f BHc..kel/ .4velllo\e. 5l.1lte. bS"O M:Q.IIl; F-L
No. Street Suite City State
3J /3 I
Zip Code
Email Address:
2)
Principal Retained by:
QUIK Pf12.K of flDf2lM--
If different from above
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):
PaJc::i"j /..ot ttWWl!4\;
4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff)
to be lobbied: rltlMW~ ~folM(..5 S~#- __ Mtv~, Tb~, Av~ .
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
o City Board or Committee
o Personnel
o Identify Others
on . 2001
on , 2001
on , 2001
on <.JUW 'ZIR, 2001
on , 2001
on , 2001
6. State the extent of any business, financial, fam' ial,. professiql}a~ or other relationship which exists with any
individual identified in number (4) above: 0 Va~ ()VJ.
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 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 amended, and all reporting
requirements. ~
Signature of Lobbyist: ~
~ persdonaldly know" ~ - l?;/Hil. -2*(,-0
,,-Pro uce ID V
Identify
~ Did take an oath, or
o Did not take an oath
If Notary, print, stamp or type as com
TARY SEAL
~G- PATRICIA A KUNDE
(\ --lnflON NUMBER
CC6lI78U
exPIlEII
OCT. II 2001
State of Florida, County of Miami-Dade
Sworn ~scrib~~b~ie m,e
This day of . 2001.
Registration:
[ ~PTED
FOR CLERK'S USE ONLY
[ ] REJECfED DATE: ~ ~ I - 6 f
If rejected, state reason:
Registration fee paid: [...pres [ ] No [] Not-fer-Profit Organization
[ ] Cash [-+etleCk MeR # ~ > '7 :J '1 (.,
DATA ENTRY DATE: C, - I . 2001 ENTERED BY~P