Alexander P. Heckler - Southern Waste Systems, LLC- ~ ~ t - ..-
City of Miami Beach Office of the City Clerk
- 1700 Convention Center Drive, Miami Beach, FL 33139 ,
LOBBYIST REGISTRATION .FORM -
'Ldbbyist 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, actidn or decision of any commissioner; any action,. decision, recommendation of the City Manager or any city board or
committee; br any action, decision or recommendation of any city personnel 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, of a city board or committee. The term
' specifically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific exclusions. Please
-" refer to Ordinance 2004-3435. '` - -
.. ' ~ . t~t'~C~~2.Q- ~ ~~P aCf~kY'Vfl d_..
~NAMEOFLOBBYIST: (Last) (first) (M.I) -
F-~ , c.~~~~-~c~i~ : r~
~nu~ d-~o~~~ .t-1-~ c~~ ~~-i- ~-r~t ,~]',tc~C~ ~l~t~ _.~-~P ~ 100 3~3~ C ~
;BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
~~115~y) ~~ ~. ~ 3 ~O I ~lsy ~ 5"a-~--~ 7G I ( ~-l~e~~ le_r-- ~ ~ ~.- ~~ .
7ELEPI-iO~tc NUh^:i~F': - _. _ .~_"......_~Fr~X`Iv " iBER: , .. ... ; _ .~ "..:._.~-~ :: ,s _ ~<EMAIL:
I. LOBBYIST RETAINED BY: ~ ~t-'"~ -
,;
_ ?NAME OF PRINCIPAL/CLIENT:.
BUSINESS NAME AND ADDRESS. (Number and Street) (City} {State) {Zip Code) "
" :TELEPHONE NUMBER: - • FAX NUMBER: (Optional)- EMAIL: (Optional)
u.~rt~ll-IC: LUtit3Y 155UE:
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Issue fo be lobbied (Describe in detail):
• '. m.CITY-AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code section 2-482(8) include •
• a statement of the extent ,of any business, financial; familial, ,professional or other relationship, giving, rise to an _ _
' appearance-of ~n impropriety with any City Viers^i^,;.~-,a7-sought to tie iobnied '-- further,`pursuant to City Code Section 2- ~ ~'
- ~ ~ 482(a)(4) include a statement of any contractual relationship. (paid or unpaid) from 12 months preceding said City '
• `;.personnel' commencement of service with the City to the present date, stating the general. nature of the subject •"
" --contractual relation.
A FuIF Name of Individual/Title B) Any Financial, Familial. or Professional Relationship
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Via' !. ~ -1 1-: i l T 3 "'l. -'9v't ~ i i ~-, ..
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ~ (~ ^OD~
(Required).- - l(_,
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
Yes ^ No: Are you lobbvinq on a present or pending bid for goods equipment or services or on a
present or pending award for goods, equipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^ Yes GVNo: Are you lobbvinq on a pending application for a Development Agreement with the City or
application for chance of zoning map designation or change to the Citv's Future Land Use
Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of anot-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees.
^ Yes ~NO: Are you representing anot-for-profit corporation or entity without special compensation or
reimbursement. .
V. SIGNATURE UNDER OATH:
Signature of Lobbyist
I do solemnly swear that al o he foregoing acts a true and correct and that I have read or am familiar with the
'provisions contained in Sec ion f the ami B \h City Code and' all reporting requirements.
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Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
~ ^ Produced ID ^ Produced ID ~ ~ ~ ~
~ ^ c ~ Form of Identification Form of Identification ~ ~ o o ~
~ ~ N C O~ N
:~ ~ tri «: ~~M O
w o W ~ Personally known (Lobbyist) ~ ,~ Personally known (Principal) 01 ~ q '" ~
z~ .~ ~°
,~ ~ ~ ~ VII. SIGNATURE AND STAMP OF NOTARY: ¢ q o w °~
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~ g State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade "' ~ ~=
~ Sworn to ar~d subscribe efore me ~ •5 o r~
Sworn an subsc ibe before me
s'` This da of , 2010 ~-+~ ~~ ~ ~ ~ w a
~ Y T ~~ day of )r[~, 2010 ~ ;, , ~
H~
ignature of Public Notary -State of Florida Signature of Public Notary -State of Florida z ~°~~~~~~~~'~,
Notarization of Lobbyist's s' nature Notarization of Principal's signature
TO BE COMPLETED BY CITY C ERK'S STAFF ONLY
Annual Registration fee: [ ]Yes [ ; ] No Amount Paid $ MCR # ate Paid
Lob,byisf Registration Form received and verified by:
F:~:~LEK~sALL}~s~-or.~tsiLO;~c~y~s-r FpPs~t~>Ist?yist E~tegi~trats~sa~ I°ar~, 2U~tt,ctoc Revised 05/05/2010
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"!City trf Miami Beath, 1700 Convention Center Drive; Miami 6edch, Florida 33'139, www.miamibeachfl:gov
,•, , CITY CLERf< Office; • - CityClerk@miamibeachfl.gov F ,
FTeI: 305.6737411 ,Fax: 305.673.7254
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• ri . 'Acknowledgement of fines/suspension from lobbying. for failure to
• ~- „ comply. with City _of Miami, Beach lobbying Laws
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. `. .~ .LOBBYIST NAME: - ~ IMP }C~i4-(~~`e-'C~ ~ ~ ~~~\~ ..
-' ~~°i und'e~stand that no later°tFiari October l st` of`ecch year; 'fobbyis`fs subject to lobbyisf "~` -~ " J T"'--~'
,registration. requirements shall submit to the city- clerk a signed statement under-oath
f ~ listing all' lobbying expenditures; as well as compensation received; for -the preceding
calendar year with regard .fo the specific issue on which the lobbyist. has been engaged
'to .lobby. A statement shall. be. filed even if there have been -no expenditures or
compensation duping the reporting period.; The, statement shalt list; in .detail, .each
expenditure, •,kiy category,including. food 'and beverage; entertainment; research;
.' communication, media advertising, publications, travel, lodging and special events.
.: ,• -~
Failure #o timely •fle the expenditure and fee disclosure report will result .
" in a fine of. $50.00 per. day. Any lobbyist who fails to file the required
' :expenditure' report by .December 1
shall automatically be suspended
'.from lobbying unfit all fines, are paid, unless the fine has been appealed ;
. ;to the Miami-Dade Coa~nty Commission on Ethics and Public Trust. In he '
.. _ event a lobbyist fails to ei#her` file the report and/or pay the assessed fines; the Clerk shall
notifythe~Miami Dade County Commission on Ethics and Public Trust.
i
In addition,-once an issue.I have registered`to lobby on has been resolved, I am required
to im 'c~tely.noti. •the Cay~-Clerk's Office of !cbbyist withdrawdl in writing. ';
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