Kent Harrison Robbins~ S'~~%
m MIAMIBEACH
City of Miami Beach Office of the City Cferk
1700 Convention Center Drive, Miami Beach, FL 33139
Supplemental LOBBYIST REGISTRATION FORM
Lobbylsl means all parsons employed or retained, whether paid or not, by a prindpal who seeks to eneeuraga the passage, defeat or modilicallon of
any ordinance, resolution, action or dedsion of any commissioner, any acton, dadslon, recommondatbn o1 the Clty Manager or any city board or
commUlee; or any action, dedalon or recommondallon of any dly personnel durfng the lime period of the entire dadalon-making process on such
action, derision or recommendetlon that fareseeabiy will be heard or reviewed by the dly commission, or a dly board or committee. The term
spedfically includes the prindpal as well as any employee errpaped !n lobbying adivHles. The term "Lobbyists" has apecinc exclusions. Please
refer to Ordinance 2004-34311.
Robbins Kent Harrison
NAME OF LOBBYIST: (Last) (First) (M.I)
Kent Harrison Robbins, 1224 Washington Avenue, Miami, FL 33139
BUSINE5S NAME AND ADDRESS (Number and Slreel) (City) (Stale) (Zip Cade)
(305) 532-0500 (305) 531-0150 khrobbins®kentharrisonrobbins.com
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
LOBBYIST RETAINED BY:
Wvxld Waste Services, Inc.
-NAME OF PRINCIPALlCLIENT:
4701 NW 35 Avenue Miami FL 33142
BUSINESS NAME AND ADDRESS (Number and Street) (City} (Slate) (Zip Code}
(305) 636-4939 {305) 633-8226 edamasoi~worldwasteservice.com
TELEPHONE NUMBER: FAX NUMBER: (Opllonal) 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: Michael Adame
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5°~ OR MORE OWNERSHIP INTEREST !N
SUCH CORPORATION, PARTNERSHIP OR TRUST: Michael Adams, Martha saroza, Robert Saroza
II.SPECIFIC LOBBY ISSUE:
Legal representation of World Waste Services, Inc. concerning RFQ 49-07/08
Issue to be lobbied (Describe in detail}:
_.......
III. C(TY AGENCIES/INDIVIDUALS TO BE ,LOBBIED: (Pursuant to City Code section z-aszie1
include a statement of the extent of any business, financial, familial, professional or other relationship, giving raise to an
appearance of an impropriety, with any City personnel sought to be lobbied; further, pursuant to City Code Section z-
482(a)(4) include a statement of any contractual relationship (paid or unpaid} from t2 months preceding the
commencement of service of Ctty personnel to be lobbied.)
A Full Name of Indivlduai Tide - B "An Financial, Familial or Arotessional Relatlonshl
Procurement, Gus Lopez None.
Mayor & City Commission None.
Evaluation Committee None.
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT
RATE OR OTHER):
A) LOBBYIST DISCLOS RE: (Required)
$475.OOyhr
B) PRINCIPAL'S DISCLOSUR (OF LOBBYIST COMPENSATION):
(Required). $475.OO~hr
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 lobbvina on a present or pendina bid for aoods. eauipment or services, or on a
present or pendina award for aoods. eauipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On
Real Estate Development Issues":
^ Yes ~ No• Are you lobbvina on a pendina application for a Development Agreement with the City or
application for chance of zoning map designation or chance 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 snot-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:
I do solemnly swear th al of
provisions contained in a to ~
and that I have read or am familiar with the
all reporting requirements.
~~
VI. LOBBYIST IDENTIFICATION:
^ Produced ID
Form of Identification
personally known (Lobbyist)
VII.
SIGNATURE AND ST
State of Florida, County of
Sworn to and subscribed b
This '~: day of
Signature of Public
Notarization of Lo
PRINCIPAL IDENTIFICATION:
~L ~-; ~ 111111
Produced ID •Tf ~~ ~` ~~_:W`~~pIN~fi'~/~~~7//
Form of Identificati~l .••'MMIS8i•'~r~~/~~%
r •,~cA oN :~l
~ e,~Nary 1g ~ O.
~~IIIi1RINli/for s * ~ `~ ao s
`\~~~~\PM •• 11gT~~i~4 ^ Personally known (Principal) =o : ~~_ W m ;
~~~ ~ N ~ * _ Swoen and subsc be ty oforel me Da~Ei~~~rr r i tl-!i N«~\`\\
~~ 832367
~~ laQ-` This~day of ~ ~"N~` , 200
i~ 6 .•••Ta~OF;~ Zti ~'• '
- St to of Flo 6rlilliiliitlte,~ Signature of Public Notary - St a of lorida
5-signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes ( ] No Amount Paid $ MCR # Date Paid
Lobbyist Registration Form received and verified by:
r:~c~~r~~~.r~I~aY~~T?,I.c:~~~- -° w .: ; { r:s~n ~x~aoa,d~c Revised 03/27/2008
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