City Of Miami Beach

Lobbyist Fee Expenditure and Compensation Form

City Code Section

2- 485

f. r 7

n .

2016 JAN 28
Expenditure

for

report

period of: 1/ 1/

2015 through 12/ 31/ 2015

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PM
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A statement shall be filed even if there have been no expenditures or compensation during the reporting period.

53

OFF ICE

This statement is to be signed, notarized and returned to the City of Miami Beach, City Clerk's Office, 1700 Convention Center Drive,
Miami Beach, FL 33139 by February 28th. A fine of$ 50.00 per day, per issue, shall be assessed for statements filed after the due
date. If you require any assistance, please contact this office at 305.673.7411 or at citvclerk@miamibeach.eov.
Lobbyist

Michael Marrero

Principal

Don Peebles/

Issue

Bath Club Entertainment, LLC

Board of Adjustment Appeal regarding Use of Pool Deck and Facilities at 5937 Collins Avenue.
PLEASE COMPLETE THE SECTION BELOW
460

Detail Compensation Received:

per

hour

CATEGORIES OF EXPENDITURES
Food

and

Beverage:

Entertainment:

Research:

0
0

Communications:
Media

Advertising:

Publications:
0

Travel:

Lodging:

Special Events:

CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE
DATE REPRESENTATION ENDED:
OATH

State of Florida

County of Miami- Dade

I, the

undersigned

lobbyist, do

hereby

depose

under oath and affirm

that the information

disclos-

herein .

hereto are true and correct.

attachment

ri

SIGNATURE AND STAMP OF NOTARY:

obbyist . i:.- nature

I, /

P oduced ID
Form of Identification

Personally

known

Signature

of

Swor

and s .

This day o _!
ow

is

Notary State of Florida

scribed Wore me
.

o l

Notary Public State of Florida ,

'

Diana Ramos

140,

My Commission FF 207719
Expires 04/ 10/ 2019

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