0001209191-17-046801.txt : 20170731
0001209191-17-046801.hdr.sgml : 20170731
20170731182158
ACCESSION NUMBER: 0001209191-17-046801
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20170725
FILED AS OF DATE: 20170731
DATE AS OF CHANGE: 20170731
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pegula Kim S
CENTRAL INDEX KEY: 0001713201
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-14267
FILM NUMBER: 17994180
MAIL ADDRESS:
STREET 1: 18500 N. ALLIED WAY
CITY: PHOENIX
STATE: AZ
ZIP: 85054
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: REPUBLIC SERVICES, INC.
CENTRAL INDEX KEY: 0001060391
STANDARD INDUSTRIAL CLASSIFICATION: REFUSE SYSTEMS [4953]
IRS NUMBER: 650716904
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 18500 N. ALLIED WAY
CITY: PHOENIX
STATE: AZ
ZIP: 85054
BUSINESS PHONE: 480 627 2700
MAIL ADDRESS:
STREET 1: 18500 N. ALLIED WAY
CITY: PHOENIX
STATE: AZ
ZIP: 85054
FORMER COMPANY:
FORMER CONFORMED NAME: REPUBLIC SERVICES INC
DATE OF NAME CHANGE: 19980423
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2017-07-25
0
0001060391
REPUBLIC SERVICES, INC.
RSG
0001713201
Pegula Kim S
18500 N. ALLIED WAY
PHOENIX
AZ
85054
1
0
0
0
Common Stock
0
D
Restricted Stock Units
0.00
Common Stock
1485
D
As initially reported in Ms. Pegula's Form 4 filing dated July 27, 2017, she was elected to the Board of Republic Services, Inc. ("Company") effective July 25, 2017. The Company annually grants, as of the first business day in January, each non-employee director a grant of restricted stock units ("RSUs") pursuant to the Company's 2007 Stock Incentive Plan, as amended. The grant is based on a value on the date of grant of $220,000, with the number of RSUs calculated based on the closing stock price of the Company's common stock on the date of grant. The RSUs immediately vest; however, the director cannot convert any of the RSUs to Company common stock (based on 1 on 1 conversion) until the earlier of the last day of the month in which the three year anniversary of the date of the award occurs unless deferred by the director or the date on which the director incurs a separation from service within the meaning of Section 409A of the Internal Revenue Code.
As initially reported in Ms. Pegula's Form 4 filing dated July 27, 2017, the annual grant of RSUs to a newly appointed director is prorated to the number of days remaining in the calendar year. After any quarter in which dividends are distributed to shareholders, the director receives additional RSU equivalents. The amended Form 4 filing dated July 31, 2017 corrects the administrative error in the number of RSUs granted to Ms. Pegula as previously reported in the Form 4 dated July 27, 2017. Ms. Pegula was granted 1,485 RSUs as of July 25, 2017 ("Date of Grant"), based on the remaining 160 days in the calendar year and closing stock price of $64.98 as of the Date of Grant. The RSUs are scheduled to convert to common stock as of July 31, 2020.
/s/ Eileen B. Schuler Attorney-in-Fact
2017-07-31
EX-24.3_738297
2
poa.txt
POA DOCUMENT
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned's hereby makes, constitutes
and appoints Eileen B. Schuler as the undersigned's true and lawful
attorney-in-fact, with full power and authority as hereinafter described on
behalf of and in the name, place and stead of the undersigned to:
(1) prepare, execute, acknowledge, deliver and file Forms 3, 4, and 5 (including
any amendments thereto) with respect to the securities of Republic Services,
Inc., a Delaware corporation (the "Company"), with the United States Securities
and Exchange Commission, any national securities exchanges and the Company, as
considered necessary or advisable under Section 16(a) of the Securities Exchange
Act of 1934 and the rules and regulations promulgated thereunder, as amended
from time to time (the "Exchange Act");
(2) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the Company's securities from any third
party, including brokers, employee benefit plan administrators and trustees, and
the undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such release of
information; and
(3) perform any and all other acts which in the discretion of such
attorney-in-fact are necessary or desirable for and on behalf of the undersigned
in connection with the foregoing.
The undersigned acknowledges that:
(1) this Power of Attorney authorizes, but does not require, such
attorney-in-fact to act in their discretion on information provided to such
attorney-in-fact without independent verification of such information;
(2) any documents prepared and/or executed by such attorney-in-fact on behalf of
the undersigned pursuant to this Power of Attorney will be in such form and will
contain such information and disclosure as such attorney-in-fact, in his or her
discretion, deems necessary or desirable;
(3) neither the Company nor such attorney-in-fact assumes (i) any liability for
the undersigned's responsibility to comply with the requirement of the Exchange
Act, (ii) any liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and
(4) this Power of Attorney does not relieve the undersigned from responsibility
for compliance with the undersigned's obligations under the Exchange Act,
including without limitation the reporting requirements under Section 16 of the
Exchange Act.
The undersigned hereby gives and grants the foregoing attorney-in-fact full
power and authority to do and perform all and every act and thing whatsoever
requisite, necessary or appropriate to be done in and about the foregoing
matters as fully to all intents and purposes as the undersigned might or could
do if present, hereby ratifying all that such attorney-in-fact of, for and on
behalf of the undersigned, shall lawfully do or cause to be done by virtue of
this Limited Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked by
the undersigned in a signed writing delivered to such attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 24th day of July, 2017.
/s/ Kim S. Pegula
Signature
SUSCRIBED and SWORN to before me, the undersigned notary public, on July 24,
2017.
/s/ Barbara Ann Fagyas
Notary Public in and for the State of Arizona
Notary Seal
My Commission Expires: 04.07.2019