2024 Lobbyist Registration Form - Single Hauler Trash Collection (Kurt Salac) S�,�y� I�.� l� T,�..��,
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MIAMI BEACH ' 'N 19z°ZQ
Office ofthe City Clerk
1700 Convention CenterDrive �,�TY U!-;4qIAMl BEACH
Miami Beach, FL 33139 ��F'��`�-t '.'��� r'll y�! EqK
305.673.7411
L0B8YIST REGISTRATION FORM
Lobbyist means all persons employetl or retaineQ whether paitl or not, by a pnncipal who seeks�o encourage ihe passage, tlefeal or
modifica[ion of any ordinance, resoWtion, action or tlecision of any commissioner; any actioq tlecision, recommentlation of Ihe City
Manager or any Ciry board or committee;or any action,decision or rewmmentlation of any Ciry personnel tluring the time periotl ot ihe
entire tlecision-making pmcess on such actian, decisian or recommendation [ha� foreseeably will be heard or reviewetl by �he Ci�y
mmmission, or a City boartl or committee. The term specifcally indudes ihe principal as vrell as any employee engagetl in lobbying
ac[ivities.The term"Lobbyists" has specific ezclusions. Please refer ro City Cotle Chapter 2,AM1icle Vll, Division 3, entitletl"LobOyisls,"
for atltlitional information.
Instmctions: Please complele all sections of ihis form antl submil the completetl form,with the applicable fee, to the OKce of(he Ciry
Clerk. If you need more space to complete an answer, use a sepa2te sheet(s)of paper. If you have nothing ro report in a particular
sectiort. you must wnte "none` or "nla" in ihat seclion. Any change to any information onginalty fleQ or any atltli�ional City
Commissioner or personnel who are also sought ro be lobbied shall reQuire that ihe lobbyist file an amentlment to the regisiretion form.
The lobbyist has a mntinuing tlury to suppry information antl amentl �he torms (iletl IhroughoW the penotl that lhe lobbying occurs.
Separete regisiretion fortns shall be requiretl for each principal represenled on each speci(c issue.
1. LOBBYIST INFORMATION:
Laikin Michael W.
NAME OF L089vIST (Las�) (Flrs�) (Mitlele Name)
Bermw Radell Fernandez Larkin& Tapanes, PLLC 200 S. Bixayne Blvd., #30Q Miami, FL 33131
LOBBVISTBUSWESSNAMEANDA�DRESS (Numberentl5[reel) (Ciry) (S�ele) (ZlpGotle)
305-374-5300 mlarkinC�brzoninglaw.com
LOBBVISTBUSWESSTELEPHONENUMBER CELLULARTELEPHONENUMBER EMAILAODRESS
II. PRINCIPAL INFORMATION:
Salac Kurt
NAMEOFPRWCiPAL (Lasl) (Flrsp (MitltlleName)
Wastc Connecfions of Florida, Inc. 3 Waterway Square Place,Suite 110,The Woodlands,TX 77380
PRINCIPALBUSMESSNAMEAN�AOORE55 (NumberantlStreel) (Cly) (3�ale) (LpCotle)
832-442-2240 kurtsalac@wasteconnections.com
PRINCIPALBUSMESSTELEPHONENUMBER CELWLARTELEPHONENUMBER EMAILADDRESS
Pursuan�to C�y Cotle Sec�ion 2-482(h)(1)(a)' A pnncipal M arry corporalqn, paMersHp, or oNer en�iry wM appears as a bbbyis�on�ehaR M Ihat
enMy,wi�M1w1 spacial canpensa�ion o�reimDursemen�fo�Pe appea2nce.wbel�er Oi�ect intlirect or conUngen�.�o�prew supporl of or opposil'an b
an i�em sM1all regis�er wiM�M1e Cled a5 repuired by��is subsectlon Dut s�all nol Ee 2puireE�o OaY any regis��'dlion fees.
If the principal is a Corporation, Partnership or 7rust, the following information MUST be provided
- pursuant to City Code Section 2-482(c�:
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARV(if none,write N/A�: NIA
- • NAME OF ALL PERSONS HOLDING, DIRECTLV OR INDIRECTLV,A 5%OR MORE OWNERSHIP INTEREST IN SUCH
- CORPORATION,PARTNERSHIP OR TRUST(H none,wnte NIA�:
Florida Waste HoldinQs, Inc. -100%
Page 1 of 5 �� �
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III. ISSUE TO BE LOBBIED:
Daacribs with as much deWil as is praetieal, ineluding but not limibd lo e speeffle dascriptlon where
applieabla of a panding requeat for proposal, Invitatfon to bid, or public haariny numbar.
2023-2024 Trash Collection RFQ and Discussion Item concerninQ issue of sin�le hauler in compazison
to multi-hauler for trash collection.
N. CITY AGENCIES/1NDNIDUALS TO BE LOBBIED:
Pursuant lo Ciry Coda Saetion 2�482(a)(4), Iist tha City Commisaionar or City personnel sought to ba
Iobbiad, and whether the Iob6yist has antarad into any contrectual nlationahip (paid or unpaid) with
said Clty Commissioner or City parsonnel from 12 months p�ecading such commaneemant of serviu
with the Cily to the present data, sWtlng tha gananl nature of the subjeet eontnMual relationship.
Full Name of Individual antl Contrae[ual Ralationship(M y�s,ezplain) vEs No
71t1e W Person to be Lobbied
Staff for the Ptannin &Buildin De arhnent None X
Public Works&Ci Administration, PB, HPB, BO None X
D2B,City Commission,and Mayor as necessary None X
land Use k Sustainabili Committee None X
Pursuant lo City Coda Saedon 2-482�g), avary ngiatrant ahall ba rcquirad to atata th� �#ant of any
busin�as, Flnandal, familial or profaasional relationship, or oth�r nlatlonahip gWing risa to an
appaaranca o(an impropriety, with any current Cily Commisslonar or City paroonnel who is aought to
- W lobbbd as Idmtlfled on tha lobbyfst registratlon form fllad.
= Li�t any Busii»a, Flnancial, Femilial or ProMsional RelMionnhip, or other mlrtionship yivinq ds� to an
• unnn of Im ro d if none wtlm N/A :
' None
V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION —B� Soaciflc. (Note that a
contlngency fae is prohibitad pursuant to City Code Sec. 2-A85.3):
- 3850.00 per hour
Page 2 of 5
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DoaSgn Enwbq ID:91P90D5'lEFMASAb9951ACAE982B1308
TM tollowtnp�ia(6)qu��tbns MUST M anawxed:
1� Pursuant to City Cotle Section 2-�!!,entilled'Prohibiletl Campaign Contnbutions By Lobbyisls On Procurement Iswes':
_Yn�No: Mt tll 0'tl( a A M u�v' anl or
untlina�warU tor aoodf.eoulomml w asrviee9
2) Punuanl lo Cily Cade Sec[ion 3�490,en4tletl'PmhiEiteE Campaign Contnbutions By Lobbyisls On Real Esta[e Oeveloqnent
Issues':
Yss%No: a..�..�I blw' d'na aool'ta0on(w a Dewloomwl Aanxn�nl wilh M�LiN or amliuHon
( h oi 'ra C tion ha t l� C'N' P N LanCU WD7
3) Pursuant lo City Cotle Section 2-�82�h), any person (except ihose exempt from the definilion of'IobEyisl" as set taN in
Section 2+181�wlw only appean as a repreeentative of a naF(or-profit corpaation or entlry without spaciel compensadon w
raimbursemenl fa ihe appae2nce,wTether Airecl or in0irect lo express support o!or opposition lo eny item,shall register wiM
Ihe tiry clerk as requirei Oy Mis sectlon.bu1 shall not Oe requlretl W pay any regislration(ees.
Yn X No: norq 11 �b roroft 1' Milv 'Ih t two'al 1'on
roim W n�m�n1T
4) Pursuant to Ciry Code Seclian 3�l1, Ihe teem 9obtyisl"specifically ezclutles ttro following peroons: EnpM witnesses wlio
pmvitle only scientific, lechnical or ottrer spetiaiized infortnalim or teslimony in puDlic meetings any peraon who only appears
as a represenlative ota neighborhooE association witl�oul compensalion or reimbursement(or Ihe appearance,whalhertlirxt,
indirect or contingent,to express support of or opposRion to any item;antl any person xRio only appears as a representative W
noPtwpmfit communiry basetl organization /or Iha purpwe af reQuesting a grant without spenal compensatbn a
reimtwrsemenl for ihe appeararwe.
V��xNo: s.. .. '0" 1 se'entlfie. lechn'cal or othx sosc'aliieC inform�tion: aooesrim a� a
•��•�rve ot a neiahbomooA assxletim wilhoN wselal eomoenntion or nimbunem�nt or
- M M'� tb ro!k ba tl ' atl ( P M f t 'thout
soseul eomosnulion w nimbunameM9
5) Pursuant b Ciry Cotle Seclim YJ97�7�,no campaign cansullant shall bbby the Ciry Commissim for a penotl o!12 moNhs
bllovnng Ihe aweanng in of any elecled o�c�l(s)for whan ihe campeign conwllant proviGetl pmpaign consultlng services
within Me pasl abction cycle.See Sectim 2�91 for rtrore irRormation.
_Y�s�No: ICM W 1 I M t be a/lM CN C i b
wilhin Me wst�Ncfim evcNT Hv�s.ol�a�lisl th�incumb�nl m�mMAsl olth�CiN Commission:
Y�a X N¢ ��^� lu 't bs n k lh 77 lh 810CR �h! �IlGIOE OIfC1�116)WhWI� VOY GfOVItlld CeTDli9�
C011E111111146MV�Cf6 Wd65WOT I�IZ
6) Pursuant ta City Cotle Section 4J62(a��Qa., a bbbyist who has wilhin Me pesl abction cycb proddetl wmpaign conwltirg
services to en inwmbenl memEer of IM City Commission (which lobbying acEviry is not otherwise prahititeE by COCe section
2-491� shall Ciaclose such perticular service on �is/her lobbyist regietraGon farm antl shall rnallv d'stlose such oahiwlar
befo lobb ' tM CiN Co t bt ti .
V�s X No: W��•� ^�d d -m s' �Iti a �ervlaa t 'nc mMM mxnWr of tM GiN Commiafion
� within th�mat el -Ilon evck?It vn.olaaw list Me ineumMnt m�mbMal of IM CiN Commiulon:
Yn x No: tl - d A'A � M tb ' �achanae 7or umwian
eansWtina s�rvin�7
TO BE LONPIETED 8�CRV CLERK'8 Si�iF ONLY
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= MnwlRplatr�M: [ �Y���No M,WMv.�as 35o ypR� 3300 � p�yP�ltl
- LOEDyIp RpINrWen Form rw1�nE�M vMMC M: ��
F:\RER\SALyaFORMS\LOBBTIST FORMS\�bbyis�Rcgi54atim Form Rcvisetl 09-30d8 REG.tloc RavNW 0!/M/3016
Page 3 of S
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ooasre�e�wiwe io:eineaonaFoe�sno-ess'r-ecoEsezeiaos
VI. SIGNATURES UNDER OATH:
ON FEBRUARY 28 OF E4CH YESR EACH LOBBYIST SHALI SUBMIT TO THE OFFICE OF THE CITY CLERK A
SIGNED STATEMENT UNDER OATH LISTING LOBBYING EXPENDI7URES. AS WELL AS COMPENSA710N
RECEIVED FOR 7HE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH 7HE
LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO
EXPENDITURE OR COMP 1D-URING THE REPORTING PERIOD.'
SignaWre af Lobbyisl: �� �'"'�'�' Dale m �aoma
I do solemnly swear or affrm Ihal atl of ihe foregoing faqs, statements, and disclosures in ihis form are tme and correcl,
aM Iha� I have rea0 or am familiar with Ihe provisans contained in Chapler 2, An.VII, Divisbn 3, entitled "Lobbyisls" of
the Miami Beach City Code aM all reportin uiMnienIt-s�,.��
SignatureofLobbyiSC �••w�..e��. �� �""k' Dale nv�mam.
Signature of Pnncipal: ��S� � Dale nv�ormoa
VII. NOTARY SIGNATURE AND SEAL:
LOBBYIST: PRINCIPAL
State of Florida S�ale of Florida
County o(: Miami-Dade Counry of: Miami-Dade
Swom to(or affrmed)an0 subscriEed De/ora me, Swom ro(or aifirmed)and subscnbeC before me,
by rtreans of O p�ysical presenca by means of� physical presence
or�online nofar¢ataq or�online no�arization,
Iliis_day of nv�ormoe . 20_, by Ihis_day of .20_, by
Michael W. Larkin Kurt Salac
NRME OF LOBBVIST NAME OF PRINCIPAL
ProEuced ID _ProEuced ID
FO F �
x Personally Kn � � z Personally Kn � �
� Signalure of Notary Public��'n �m Sgnature of Notary uEiica,....�.m
Diana Ramos Diana Ramos
" Name of Nolary,Typed, Printed a Stamped Name o!Notary,Typeq Prinled or Stamped
.• ( pma Ramw Duru Ramm
- Cammlulon�NN�l69P Commlaalon�NM]�6937
- NodryPublk-S�eleofFbMe No�aryPublk-Sle�eoifbrka
My Commissbn Expies Apr 16,]02l My Commisalon EMpimn Fpr 16,2(131
'Tha penons:
Ezpert witneases who provitle only uientific,�echnical a otlror spscialized infortnation a testirtwny in public meetlrgs;any parson who
` only appeare aa a represenlative of a neighEortaoE eseocielim vnMout compensafion or reimWnement for Ihe appearance,whether
� Eirecl,iMirect«conti�gent,lo expresa support of«oppositim lo any ilem;antl any prwn who only appears as a repremntative of
- notJor�rofil communiry basetl organ¢atim(or the purpoae of repueslirg a grant witMut spedal compenealim ar roimEursement for
� the eppeamnce.
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Ooa�5lgn EnvebpelD:81A90D5]-0FD115A0.995]-9COE98181306
Ciy of Miami beach, I]00 Co��e�ilo�Center Drive,Miomi Beach, Floddo 33139,ww.v.miamlbeochH.go�
Offlce oNhe Ciry Clerk
RafaelE Gronado. Cly Clerk OyClerk@miaml6eachfLgov
Tel�. 305.673741 I, Fox: 305 673 7254
NAME OF LOBBYIST: Michael W. Larkin
1� LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT
Pursuant to City Code Section 2-485(d), lhe City Clerk shall notify any lobbyist (or
prindpal)who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement
(Statement). In addition to any other penalties tliat may be imposed as provided in
Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements filed after the
due date. The City Clerk shall notify the Miami-Dade County Commission on Elhics and
Public Trust of the hailure of a lobbyist (or principal) to file the Statement or pay the
assessed fines after notification.
Any lobbyist, who fails to file ihe required Statement by April 30"' of each year, shall be
automatically suspended from lobbying until all fnes are paid, unless the fine has been
appealed to the Miami-Dade Counry Commission on Ethics and Public Trust.
I hereby acknowledge lhal on February 28 of each year, I shall submit to the City Cleric a
signed Statemant under oath listing all lobbyist expenditures, as well as compensation
received, for the preceding calendar year with regard to the specific issue on which I have
been engaged to lobby.
2) LOBBYIST WITHDRAWAL
Once an issue I hava registered to lobby has concluded or I am no longer lobbying on
that issue, I shall immediately file a Nolice of Withdrawal with the Oifice of the Ciry Clerk.
� 3) ANNUAL LOBBYIST REGISTRATION FEE
I understand annual registration of all lobbyists shall be required for each 12-month period
; commencing October 1 of each year, and the fee for such annual registration shall be
$500.00 pursuant to SecGon 2�82 of the Miami Beach City Code.
- �•� �I a���.1..�:
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� 01I19R0]�
- Signature o�o�`�`yis� Date
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