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DS-DE 12 Samuelian 2015-G3 CAMPAIGN TREASURER'S REPORT SUMMARY (1) Mark Samuelian OFFICE USE ONLY Name t Z (2)2 10 Venetian Way#1502 P AA, Address (number and street) Miami Beach, FL 33139 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): 12 Candidate Office Sought: Miami Beach City Commission, Group 6 ❑ Political Committee(PC) ❑Electioneering Communications Org.(ECO) ❑Check here if PC or ECO has disbanded ❑ Party Executive Committee(PTY) ❑Check here if PTY has disbanded ❑ Independent Expenditure(lE)(also covers an ❑Check here if no other IE or EC reports will be filed individual making electioneering communications) (5) Report Identifiers Cover Period: From 10 / 17 / 15 To 10 / 29 / 15 Report Type: 2015-G3 f2 Original ❑Amendment ❑Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks $ , 6 , 630 .00 Expenditures $ , 39 , 363. 50 Loans $ , 50 ,000 .00 Transfers to Office Account $ Total Monetary $ , 56 , 630 . 00 Total Monetary $ , 39 363 . 50 In-Kind $ , 13 . 02 (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , 432, 810 . 00 $ , 294 , 266 . 33 (11)Certification It is a first degree misdemeanor for any person to falsify a public record(ss.839.13,F.S.) I certify that I have examined this report and it is true,correct,and complete: (Type name) Laura Dominguez (Type name)Mark Samuelian ❑Individual(only for IE El Treasurer 0 Deputy Treasurer © Candidate ❑Chairperson(only for PC and PTY) or electioneering comm.) 1 X ?\A X 7: Signature Signature DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS Pcc CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS Mark Samuelian (1) Name (2) I.D. Number 10 17 2015 10 29 2015 1 4 (3) Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First,Middle) Sequence Street Address& Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Description Amendment Amount Oroza, Joseph 10 18 15 4643 Prairie Avenue Miami Beach, FL 33140 1 I Retired CHE $50.00 Aronson, Michael 10 19 15 1900 Sunset Harbor Dr / Miami Beach, FL 33139 2 I Business CHE $100.00 Consultant . . Stardust Coffee 10 20 15 775 17th Street / / Miami Beach, FL 33139 3 B Restaurant INK Water for $13.02 Poll Workers Haley, Barry 10 ! 22 , 15 5750 Rose Terrace Plantation, FL 33317 4 I Attorney CHE $500.00 Pinsky, Steve 10 23 15 147 Sutton Drive Plainview, NY 11803 5 I CFO CHE $50.00 10 24 15 Turken, Dana 108 - 4th Dilido Terrace 6 Miami Beach, FL 33139 I Retired CHE $100.00 Renovation Dream Team 10 25 15 505 W 31 Street / / Miami Beach, FL 33140 7 B Construction CHE $100.00 DS-DE 13(Rev.11113) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES , a I )�g e 2 r CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS Mark Samuelian (1) Name (2) I.D. Number 10 17 2015 10 29 2015 2 4 (3) Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First,Middle) Sequence Street Address& Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Description Amendment Amount Finkel, Mark 10 27 15 7300 Ocean Terrace / / Miami Beach, FL 33141 8 I Retired CAS $20.00 Samuelian, Mark 10 , 28 1 .15 10 Venetian Way #1502 Miami Beach, FL 33139 9 LOA Private Fin CHE $50,000.00 Investor Donnelly, James 10 29 15 915 Jefferson Avenue / / Miami Beach, FL 33139 10 I Retired CHE $10.00 Dominguez, Laura 10 29 15 10 Venetian Way #1502 / / Miami Beach, FL 33139 11 I Sales CHE $25.00 Manager Lewis, Harold 10 29 15 10343 SW 126th Street / / Miami, FL 33176 12 I Retired CHE $500.00 Realtors Political 10 29 15 Activity Committee / / Florida 13 200 Monroe Street F Real Estate CHE $1,000.00 Tallahassee, FL 32301 Realtors Political 10 29 15 Action Committee / / Florida 14 200 Monroe Street F Real Estate CHE $1,000.00 Tallahassee, FL 32301 DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CN V )-)of:- I( CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS Mark Samuelian (1) Name (2) I.D. Number 10 17 2015 10 29 2015 3 4 (3) Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First,Middle) Sequence Street Address& Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Description Amendment Amount Realtors Political 10 29 15 Advocacy Committee / / 7025 Augusta National 15 Drive F Real Estate CHE $1,000.00 Orlando, FL 32822-5017 PMC, LLC 10 29 15 6200 NW 167 Street / / Miami Lakes, FL 33014 16 B Automotive CHE $1,000.00 Industry Aviv, Irit 10 29 15 1530 West 22nd Street / / Miami Beach, FL 33140 17 I Property CHE $50.00 Owner Aberbach, Beverly 10 29 15 911 West 47 Court / / Miami Beach, FL 33140 18 I Retired CHE $100.00 Mouzon, Wanda 10 29 15 744 10th Street 111 / / Miami Beach, FL 33139 19 I Designer CHE $50.00 Bacon, Evan 10 29 15 1100 11th Street #406 / / Miami Beach, FL 33139 20 I Real Estate CHE $25.00 Broker 10 29 15 Heid, Christopher 818 Michigan Ave. / / Miami Beach, FL 33139 21 I City Planner CHE $100.00 DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 1 'PAT -L-40-0) , CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Mark Samuelian (1) Name (2) I.D. Number 10 17 2015 10 29 2015 4 4 (3) Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last,Suffix, First, Middle) Sequence Street Address& Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Description Amendment Amount Frank, Herb 10 29 15 10 Venetian Way / / Miami Beach, FL 33139 22 I Retired CHE $250.00 Russo, Lisa 10 29 15 314 Hummingbird Point / / Jupitor, FL 33458 23 I Retired CHE $100.00 Crespo, Adolfina 10 29 15 6028 SW 133 Place / / Miami, FL 33183 24 I Retired CHE $500.00 / / / / / / / / DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Pce G CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1)Name Mark Samuelian (2)I.D.Number (3)Cover Period 10 / 17 /2015 through 10 / 29 / 2015 (4) Page 1 of 5 (5) (7) (8) (9) (1 0) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount Whole Foods Voter Lunch 10 /181 15 1020 Alton Road Miami Beach, FL 33139 MON $40.99 1 10 18 15 / Publix Food and Beverage 1920 West Avenue for Voter Event Miami Beach, FL 33139 MON $60.94 2 Anedot CC processing fee 10 18 15 5555 Hilton Avenue / / Baton Rouge, LA 70808 MON $2.25 3 Vargas, Luis Alberto Entertainment at 2 10 19 15 480 NW 13th Street events today / / North Miami, FL 33162 MON $300.00 4 McCrea, Penny Copy Editing 10 19 15 6200 SW 63 Court / / South Miami, FL 33143 MON $180.00 5 Publix Lunch for poll 10 22 15 1920 West Avenue workers / / Miami Beach, FL 33139 MON $110.34 6 Publix Coffee for poll 10 22 15 1920 West Avenue workers / / Miami Beach, FL 33139 MON $4.15 7 The Shoppes at West Avenue Parking for Voter 10 / 23/ 15 959 West Ave. Event Miami Beach, FL 33139 MON $5.00 8 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES E;oc:)/ CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1)Name Mark Samuelian (2)I.D. Number (3)Cover Period to / 17 / 2015 through 10 / 29 / 2015 (4)Page 2 of 5 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount Publix Lunch for Voters 10 /23 /15 1920 West Avenue Miami Beach, FL 33139 MON $71.49 9 10 23 15 I / Publix Coffee for voters 1920 West Avenue Miami Beach, FL 33139 MON $7.66 10 Oliver's Bistro Voter Breakfast 10 I 23/ 15 959 West Avenue Miami Beach, FL 33139 MON $396.02 11 National Campaign Resource Group Mailings 10 23 15 11380 Properity Farms Road #221E / / Palm Beach Gardens, FL 33410 MON $4,497.60 12 Miami-Dade County Voter Data 10 23 15 111 NW First Street / / Miami, FL 33128 MON $240.00 13 Blueprint Consulting Phone Banking/Poll 10 23 15 PO Box 310561 Workers / / Miami, FL 33231 MON $7,538.09 14 Anedot CC Processing Fee 10 23 15 5555 Hilton Avenue I / Baton Rouge, LA 70808 MON $2.25 15 AmericaTeve Media Buy 10 / 26/ 15 13001 NW 107th Ave Hialeah Gardens, FL 33018 MON $12,240.00 16 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 1 X7001 r 1 CAMPAIGN TREASURER'S REPORT-ITEMIZED EXPENDITURES (1)Name Mark Samuelian (2) I.D.Number (3)Cover Period 10 / 17 /2015 through 10 / 29 / 2015 (4)Page 3 of 5 (5) (7) (8) (9) (10) (11) Date Full Name Purpose ,. (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount Comcast Media Buy 10 /26 /15 1800 NW 49 Street Ft. Lauderdale, FL 33309 MON $4,258.00 17 10 26 15 Campaign Statistical Data Analysis/ / / 1966 NE 123RD Street Research North Miami, FL 33161 MON $3,411.00 18 Manolo Restaurant Voter Breakfast 10 /26 /15 7300 Collins Avenue Miami Beach, FL 33140 MON $293.03 19 4 Serrano, Berta EV poll work 10 26 15 800 Washngton Avenue / / Miami Beach, FL 33139 MON $240.00 20 Avila, Calixto EV poll work 10 / 26/ 15 800 Washington Avenue Miami Beach FL 33139 MON $240.00 21 Deluxe Check Reorder 10 26 _ 15 PO Box 742572 / // Cincinnati, OH 45274 MON $118.11 22 Epicure Market Food for event 10 26 15 1656 Alton Road / / Miami Beach, FL 33139 MON $72.93 23 Subway Poll worker lunch 10 /27 /15 7415 Collins Avenue North Beach Miami Beach, FL 33141 MON $13.38 24 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 1 QV. g CP i CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1)Name Mark Samuelian (2)I.D.Number (3)Cover Period to / 17 / 2015 through 10 / 29 / 2015 (4)Page 4 of 5 (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount Stardust Coffee Poll worker lunch 10 it 27/ 15 775 17th Street City Hall Miami Beach, FL 33139 MON $36.75 25 10 27 15 Publix 1045 Water for poll I / Dade Boulevard workers Miami Beach, FL 33139 MON $7.02 26 Wanerman, Cindy Poll worker Parking 10 / 2/15 1330 West Avenue for 11 days Miami Beach, FL 33139 MON $55.00 27 Physical Advertising Works Metal Stands 10 2 8 15 6713 NE 3 Avenue / Miami, FL 33137 MON $52.97 28 Community Newspapers Community newspaper 10 28 15 PO Box 431970 ad / / South Miami, FL 33243 MON $262.00 29 Blueprint Consulting Campaign 10 28 15 PO Box 310561 Administration Miami, FL 33231 MON $4,024.75 30 Blueprint Consulting Phone Banking 10 28 15 PO Box 310561 I / Miami, FL 33231 MON $448.00 31 Stardust Coffee Poll Worker Lunch 10 /28 /15 775 17th Street Miami Beach, FL 33139 MON $53.96 32 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES i -4tC eG II 1 CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2)I.D.Number (3)Cover Period 10 / 17 / 2015 through 10 / 29 / 2015 (4) Page 5 of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (6) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount Anedot CC Processing Fee 10 /29 /15 5555 Hilton Avenue Baton Rouge, LA 70808 MON $0.69 33 10 / 29/15 Stardust Coffee Poll Worker Lunch 775 17th Street Miami Beach, FL 33139 MON $52.96 34 Anedot CC Processing Fee 10 / 29 _15 5555 Hilton Avenue /J Baton Rouge, LA 70808 MON $4.20 35 Anedot CC Processing Fee 10 29 15 5555 Hilton Avenue Baton Rouge, LA 70808 MON $2.25 36 Anedot CC Processing Fee 10 it 29/15 5555 Hilton Avenue Baton Rouge LA 70808 MON $1.27 37 Anedot CC Processing Fee 10 /29 / 15 5555 Hilton Avenue Baton Rouge, LA 70808 MON $4.20 38 Anedot CC Processing Fee 10 / 29/ 15 5555 Hilton Avenue Baton Rouge, LA 70808 MON $10.05 39 Anedot CC Processing Fee 10 / 29/ 15 5555 Hilton Avenue Baton Rouge, LA 70808 MON $4.20 40 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES L U I Of) CAMPAIGN LOANS REPORT ITEMIZED Page 1 of 1 (PLEASE TYPE) FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: Mark Samuelian 10 Venetian Way#1502 Miami Beach, FL 33139 OCCUPATION: Private Financial (nest OCCUPATION: AMOUNT OF LOAN: $50,000.00 AMOUNT OF LOAN: DATE RECEIVED: 10/28/2015 DATE RECEIVED: FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: OCCUPATION: OCCUPATION: AMOUNT OF LOAN: AMOUNT OF LOAN: DATE RECEIVED: DATE RECEIVED: FULL NAME AND ADDRESS OF LENDER: FULL NAME AND ADDRESS OF LENDER: OCCUPATION: OCCUPATION: AMOUNT OF LOAN: AMOUNT OF LOAN: DATE RECEIVED: DATE RECEIVED: DS-DE 73A(Rev.08/03) age I10-III r - - f.1.., '1: • ..- . 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