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Alexander I. Tachmes - Southern Waste Systems, LLC- , ~(~ a g t g ~~~ ~-~ . City of Miami Beacli Office of the City Clerk ". 1700 Convention Center Drive,. Miami Beach, FL 33139 . LOBBYIST REGISTRATION FORM: ' Lobbyist means alb persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat or modification df ' any ordiriance, resolution, action or, decision, of 'any commissioner;. any action, decision, recommendation of the City Mahager or any city board or committee; or any adtion, decision or recommendation of any city personnel during the 4ime 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 citytioard or committee.. The term specifically includes the principal as well as any employee engaged in lobbying activities. The term "Lobbyists" has specific. exclusions. Please {efer to Ordinance 2004-3435. , . , ' Tachmes - Alexander ~ L ' NAME OF LOBBYIST: - (Last) (First) (M.I) Shutts & Bowen L'LP 201 SotzthBiscayne Boulevard, Suite 1'500, Miami,. FL 33131 BUSINESS NAME-AND ADDRESS (Number and Street) (City) ., (State) . (Zip Code) 305-347-7341 305-347-7754 atachmes@shutts:com •. TELEPHONE NUMBER. FAX EMAIL: ' 1. LOBBYIST RETAINED,BY: ,. • ~ ~ " Southern Waste Systems, LLC ~ - NAME OF PRINCIPAL/CLIENT: ' ~ ~ .790 Hillbrath Drive - • Florida 33462 BUSINESS. NAME AND ADDRESS., . (Number and Street) (City) {State) (Zip Code) ` TELEPHONE NUMBER: 561-202-2473 FAX NUMBER: (Optional) ~ EMAIL: (Optional) Fill out this section if principal is a Corporation, Partnership or• Trust [Section 2-487 (c)] . ~ NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: Anthony Lomangi•no ` ~ IDENTIFY ALL.PERSONS HOLDING,.DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST Anthony Lomangino ' _ II: SPECIFIC LOBBY ISSUE: r Issue to :be lobbied (Describe in detail): RFP - #60-08-09 for the' collection and disposal of residential waste, yard `" trash,. bulk waste' and 'operation of City's Green Waste Facility - I'll. CITY AGENCfES/I,NDIVIDUALS TO.$E LOBBIED :Pursuant to City Code Section 2-482(g) include , a statement of the extent of any' business; financial, familial, professional or other relationship, giving rise to an appearance of,an impropriety with-any City personnel sought to be lobbied -- further, pursuant to City Code-Section 2- 482(x)(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 preseht date, stating the general nature of the subject contractual relation. - A FuILName of Individual/Title. ~ B An Financial Familial or Professional Relationshi City of Miami Beach Mayor/Commissioners None City of Miarni Beach Boards/Committees None ` ,I _~~~ _ ~~ '~~ '~ ~~` ~~~ ~il~~ 'i . e t "' IV. DISCLOSURE OF TERMS AND AMOUNTS"OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR OTHER): A) LOBBYIST DISCLOSURE: (Required): $470.00 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required) - $470.00 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": . ~ I Yes L I 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 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On .Real Estate Development Issues": I,1 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 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. LI Yes ^X No: Are you representing snot-for-profit corporation or entity without special compensation or .reimbursement. . 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 Se ~n 2-482 of the Mia each City Code and all reporting requirements. Signature of Lobbyist: Signature~of Principal%Clienf: VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: LI Produced ID" LI Produced ID: Form of Identification J NOTARY PUBLIC - STATE OF FLORIDA " 11~I Persorl8~, °awn~Ib~y~ ~stian Commission #~D651416 VII. -' SIGNAf'I:] `AF~l~i41~~9~~1(~~RY: SONDEA 771EU A1'(,AN77C BONDWG GO., INC. ' State of Florida, County 'of Miami-Dade Sworn to and subscrib" d before me ' This day of , ?y010 ~ s ~-~- i n re f Public Notary -State of Florida Notarization of Lobbyist's signature TO BE COMPLETED BY Lobbyist Registration Form. received and verified by F: CLER $ALl~aF062P7S\LC}~BYIST FORMS\t.obbyist Registration Form of Idehtification LI Personally known'(Principal) State of Florida, County of Miami-Dade Sworn and subscribed before me This day of , 2010 Signature of-Public~Notary - Stafe of Florida' Notarization of Principal's signature CLERK'S STAFF//O~~NL' ~l~ll~ ~~~~L'L' Revised 05/05/2010 ` V. SIGNATURE UNDER OATH: IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY, FLAT RATE OR O,THER): A) LOBBYIST DISCLOSURE: (Required): $470.00 B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ~Th'e following information must be answered: (Required) - $470.00 1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists On Procurement Issues": 0I Yes LI 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": I.,I Yes:. ~No: Are you lobbvinq on a pending application for a Development Aareement with the Citv 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 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. LI Yes ~No: Are you representing anot-for-profit corporation or entity without special compensation or reimbursement:.. Signature of Lobbyist Alexander I. Tachmes 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 ofthe Miami Beach City Code and all reporting requirements. Signature of Lobbyist:. ' ~iynature cf Principal/Client: ~(i"~-lam VL LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION: LI'Produced ID" Form of Identification ' • . LI Personally known (Lobbyist) VII. SIGNATURE AND STAMP OF NOTARY: State of Florida, County of Miami-Dade Sworn to and subscribed before me 'This day of , 2010 Signature of Public Notary -State of Florida • Notarization of Lobbyist's signature LI ProducedlD: Form of Identification q ~~^'c.i .-, ;~ ~ o ,.~ M N O ~O ..y U o~q~~ ~a] a E--. q W O Q O ~ V cv.~'~ S o ~ ~ ~~W~ ~. z ~•,,,,, Personally known (Principal) State of Florida, County of Miami-Dade Swor subscJr'~~ before me Thi ~ day of /// , 2010 ~~-~'n1~~iLk=Y~-.t~-~'ho gnature gfJ'ublic Notary-`State of Florida __~ Notarization of Principal's signature. TO BECOMPLETED BY CITY CLERK'S STAFF ONLY Annual'Re9ictration faP• ~ ~ YPC ~ ~ Nn Amnimt Pairl R MC`R 8 natP Pairs Lobbyist Registration Form received and verified.tiy: ~' v ~ , F: CLER (L~~~~ 59W~~#~C',~~I.£~TF€,,ir.;~it a ~.r~,- i ~, r_; ,_, ~or~ ..~;2Uc4~,- ~ r Revised 05'%,05/2010 V. SIGNATURE UNDER OATH: . ,~. .: ~~ ~ •~ ----- x City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www,miamibeachfl.yov .CITY CLERK Office CityClerk@miamibeachfl.gov Tel: 305.673.7411 ,Fax: 305.673:7254 Acknowledgement of fines/suspension from lobbying for failure to comply with City of Miami Beach lobbying Laws LOBBYIST NAME: Alexander I. Tachmes I understand that no later than October 1st of each year, lobbyists subject to obbyist ` registration requirements shall submit' to the city clerk a signed statement .under oath listing ,all lobbying expenditures, as well as compensation received, for the preceding. calendar year with regard to 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 .during the reporting .period. The statement shall list, in detail, each expenditure by category, including food and beverage, entertainment, research, communication, media advertising, publications, travel, lodging and special events. Failure to timely file the expenditure and fee disclosure report wifi 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 until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. In the event a lobbyist fails to either file the report and/or pay the assessed fines, the Clerk shall notify the Miami Dade County Commission on Ethics and Public Trust. In addition, once an issue I have registered to lobby on has been resolved, I am required to immediately notify the City.Clerk's Offiice of lobbyist .withdrawal in writing. Signature: Date: ~' /Z~ ~ d I