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Rafael E. Andrade - Southern Waste Systems, LLC t r P3Likk' C VI 'rq G it . ; ; City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 7015 jUL -7 Pik I� LOBBYIST REGISTRATION FORM CITY 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 the City Manager or any city board or committee;or 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,or 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. Andrade Rafael E. NAME OF LOBBYIST: (Last) (First) (M.I) MBeach Consulting&Solutions,Inc., 1224 Washington Avenue, Miami Beach, FL 33139 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (305)531-9511 jcasagrande@a southernwastesystems.com TELEPHONE NUMBER: FAX NUMBER: EMAIL: Please notify this office if your contact information changes:address,phone,or e-mail address. I. LOBBYIST RETAINED BY: Southern Waste Systems, LLC • NAME OF PRINCIPAUCLIENT: Southern Waste Systems,LLC 2380 College Avenue, Davie, FL 33317 BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (888) 800-7732 TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) Fill out this section if principal is a Corporation,Partnership or Trust[Section 2-482(c)] • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:Charlie Gusmano,President,CEO • IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST:Anthony Lomangino,Charlie Gusmano II.SPECIFIC LOBBY ISSUE: Collection&Disposal of Residential Solid Waste,Yard Trash,Bulk Waste,and Operation of the City's Green Waste Facility Issue to be lobbied(Describe in detail): III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4)include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's commencement of service with the city to thepresent date,stating the general nature of the subject contractual relationship. Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO title of person to be lobbied Mayor&City Commission,City Manager and Staff,City Attorney X and Staff,Procurement Director and Staff,and Public Works X Director and Staff,All City Boards and Committees X Pursuant to City Code Section 2.482(g)Every registrant shall be required to state the extent of any business,financial,familial or professional relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who is sought to be lobbied as identified on the lobbyist registration form filed. Sec 2-482(g)Any Financial,Familial or Professional Relationship None C:1Usersl cterhatllAppData 1Local\MicrosoftlWindows\Temporary Internet Files\Content.Outlook183LGQDDH1Lobbyist Registration Formrevised 5-30-2012.doc ciPC IV. DISCLOSURE'OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE:(Required) To be determined B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION): To be determined (REQUIRED). 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": X Yes_No: Are you lobbying 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 Section 2-490 Entitled Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": Yes X No: Are you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City's Future Land Use Map? 3) Pursuant to Miami Beach City Code Section 2-482(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 a not-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. • YesXNo: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement. V. SIGNATURE UNDER OATH: ON FEBRUARY 28 OF EACH YEAR.EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH. LISTING LOBBYING EXPENDITURES,AS WELL AS COMPENSATION RECEIVED. IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR COMPENSATION DURING THE REPORTING PERIOD. Signatu = Lobbyist 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 and all -porting •--meats. -w Signature of Lobbyist: pr Signature of Principal/Client: -1 ; LOBBYIST IDENTIFIC x TV,N: PRINCIPAL IDENTIFICATION: Produced ID ®Produced ID Form of Identification Form of Identification J LPL N / c 5 so- 'Personally known(Lobbyist) Personally known(Principal) a' SIGNATURE AND STAMP OF NOTARY: 5:11 kViNtvA lie w t ‘e of Florida,County of F ) State of Florida,County of Md iamr Dad8" Warn to and subscribed before e Sworn and subscribed before me :*'.'::;_ day of U..L , .' 2- zo11-- This Ia day of (-24/1,e--e-'71 ,20f2-- ZZ 1 • .. ''•• ..g'1 'a of Pu•iic -State o Iorida Signature of Public Note 'f FARINA S. WALDEN '•tarization of Lobbyist's signature Nota#lzation of Princi•: ,6 ' t9YBMY COMMISSION#FF092191 ", z.�040" EXPIRES February 12,2018 TO BE COMPLETED BY CITY CLERK'S STAFF ONLY � ry Annual Registration fee: [ j Yes[ I No Amount Paid$ MCR# Vote Poi& Lobbyist Registration Form received and verified by: C:\Users\clerhati\AppData\Local\Microsoft\Windows\Temporary Internet Files1Content.Outlook183LGQDDH1Lobbyist Registration Formrevised 5-30-2012.doc 1 i \ A D E (4,1 City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov CITY CLERK Office Rafael E. Granada, City Clerk CityClerk @miamibeachfl.gov Tel: 305.673.741 1 , Fax:305.673.7254 LOBBYIST NAME: ' '`/fIr" L O 4 rD cf I understand that no later than February 28 of each year, I must file the following form, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for all active lobbying issues. 1) LOBBYIST EXPENDITURE AND COMPENSATION FORM Failure to file these forms on a timely basis will result in my name being transmitted to the Miami-Dade County Commission on Ethics and for code violation evaluation. In addition, once an issue I have registered to lobby...on_has been.resolved, or I.am.no_. longer lobbying on that issue or for that principal, I am required to immediately notify the City Clerk's Office of lobbyist withdrawal in writing. Pursuant to Section 2-485 (d), the City Clerk shall notify any lobbyist (or principal) who fails to timely file a Statement and in addition to any other penalties which may be imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th of each year, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. 97-' /11_7_ Signature. Dat F:ICLER\SALL1aFORMS\LOBBYIST FORMSILobbyist Registration Form.doc . i- F. i ,g!.- q'-= 00 1 11_15 Miscellaneous Cash Receipt z 4i1,,, f CITY OF MIAMI BEACH S No 4 tit' Cl Cash Credit Card 0 Check# $ 0 )441v 20 i S Received of R 44(4 3.x: ,- Address 1221-i 0 a ,: ® A Qen 144 , / ,rn F ' Reel( _ 1 1-1 'iE tsi �Ic' VO' 12. '�t ?`L�5 ,2?Vic. f ' fec 0v-. 91.x, l For !'ill -lilt. �� �. �� r o 1 x ,` ,, 41 e y1- �l 4.--1■cl -Li a')A t F%in f ci i' €i l',‘'i ?' ?it. i �-r-IC Z. ) t �-.5 dt c `r 1 • : t t /` r ! INFORMATION MUST BE COMPLETED) Office f F nance Director (THIS iNFOR / By r , ! /' Account Number Oil.-1-,06 7 ei,,- � v !/j// z I - Dept: 1 t'`�`( v r c uA ExT: 7cfliff Preparer. l l C.1—) o �-0a° m r CD pro < � 0 cp Q o 0 0 Q- a u,CD -i V C 3 O r.'n O C n O D o 7 r3 rn m r rn X D z O D D r. 0 cn O v rn r Z Q w n rn w X ~• O X w rn X X -.......=j X X , O __ o _o° X w O O N W rD O to O O O i • • Salvatore, Jason From: Rafael-E:Andrade,_Esq'. <ralph @randradelaw.com> Sent: Friday, August 19, 2016 4:00 PM To: Salvatore, Jason Subject: RE: City of Miami Beach Update of Lobbyist Registration Information See responses below in RED. Regards, Ralph Rafael E. Andrade, Esquire Law Offices of Rafael E. Andrade, P.A. 1224 Washington Avenue Miami Beach, Florida 33139 T 305.531.9511 F 305.673.5734 C 305.216.2028 ralph @randradelaw.com www.randradelaw.com NOTICE: This e-mail is from a law firm, Law Offices of Rafael E. Andrade, P.A. ("Firm"), and is intended solely for the use of the individual(s) to whom it is addressed. If you believe you received this e-mail in error, please notify the sender immediately, delete the e-mail from your computer and do not copy or disclose it to anyone else. If you are not an existing client of the Firm, do not construe anything in this e-mail to make you a client unless it contains a specific statement to that effect and do not disclose anything to the Firm in reply that you expect it to hold in confidence. If you properly received this e-mail as a client, co-counsel or retained expert of the Firm, you should maintain its contents in confidence in order to preserve the attorney-client or work product privilege that may be available to protect confidentiality. From: Salvatore, Jason [mailto:JasonSalvatore @miamibeachfl.gov] Sent: Friday, August 19, 2016 1:56 PM To: 'Rafael E. Andrade, Esq.' Subject: RE: City of Miami Beach Update of Lobbyist Registration Information Hi Ralph, I also need the following two for the Consulting business: 1. Potential ATM Procurement Principal:Communitel, Inc. —Compensation:$1,000 per month 2. City's Green Waste Facility 'Principal:Southern-Waste-Systems,.LLC Compensation:$2,500 per month Thank you, vNV\ B E AC H Jason Salvatore - Office Associate Ill Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305-673-7411 www.miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. From: Rafael E. Andrade, Esq. [mailto:ralph @randradelaw.com] Sent: Friday, August 19, 2016 12:51 PM To: Salvatore, Jason Subject: RE: City of Miami Beach Update of Lobbyist Registration Information Jason: Please receive the following information in response to your letter dated July 29, 2016: Issues: 1. Design-Builder Services, Renovation and Expansion; MBCC RFP No. 2014-294-ME Principal: Clark Construction Group, LLC—Compensation: $2,000 per month payable through Llorente & Heckler, P.A. 2. Unified Development Sites and Distribution of Floor Area Ordinance; City Wide Principal: South Beach Heights I, LLC—Compensation: $10,000 flat fee If you have any questions or require additional information, please do not hesitate to contact me. Thank you. Regards, Ralph Rafael E. Andrade, Esquire Law Offices of Rafael E. Andrade, P.A. 1224 Washington Avenue Miami Beach, Florida 33139 T 305.531.9511 F 305.673.5734 C 305.216.2028 ralph @randradelaw.com www.randradelaw.com NOTICE: This e-mail is from a law firm, Law Offices of Rafael E. Andrade, P.A. ("Firm"), and is intended solely for the use of the individual(s) to whom it is addressed. If you believe you received this e-mail in error, please notify the sender immediately, delete the e-mail from your computer and do not copy or disclose it to anyone else. If you are not an existing client of the Firm, do not construe anything in this e-mail to make you a client unless it contains a specific statement to that effect and do not disclose 2