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DS-DE 12 Samuelian 2015-G2-1
CAMPAIGN TREASURER'S REPORT SUMMARY b.r ti (1) Mark Samuelian OFFICE USE ONLY Name 2016 FEB a ! PH 12: 28 (2) 10 Venetian Way#1502 Address (number and street) i_; ;% c: ; �;1 F 1 L 4 Miami Beach, FL 33139 City, State, Zip Code ❑ Check here if address has changed (3) ID Number: (4) Check appropriate box(es): 0 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(IE)(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 / 03 / 15 To 10 / 16 / 15 Report Type: 2015-G2 ❑ Original ig Amendment ❑Special Election Report (6) Contributions This Report (7) Expenditures This Report Monetary Cash &Checks $ , 3 , 180 .00 Expenditures $ , 78, 302 . 01 Loans $ , 50 , 000 . 00 Transfers to Office Account $ • Total Monetary $ , 53 , 018 . 00 Total Monetary $ , 78 , 302. 01 In-Kind $ , 300.00 (8) Other Distributions $ , (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ , 376 , 180 . 00 $ , 254 , 321 . 03 (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 0 Treasurer ❑Deputy Treasurer 0 Candidate ❑Chairperson(only for PC and PTY) or electioneering comm.) X X ir Signature Signature DS-DE 12(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS I I CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS Mark Samuelian _ (1) Name (2) I.D. Number 10 03 15 10 16 15 1 3 (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 Liebman, Nancy 10 05 15 9 Island Avenue / / Miami Beach FL 33139 Snacks I Retired INK at $50.00 1 Event Amend, Michael 10 05 15 7330 Ocean Terrace / / Miami Beach FL 33141 I Retired CHE $100.00 2 Esquivel, Cindy 10 06 15 140 Jefferson Avenue / / Miami Beach FL 33139 Snacks I Marketing INK at $50.00 3 Event Bonessi, Brad 10 08 15 7330 Ocean Terrace / / Miami Beach FL 33141 Snacks I Visual INK at $200.00 4 Designer Event Hoffman, Carol 10 08 15 4740 Alton Road / / Miami Beach FL 33140 Exec CHE 5 Director Roman, Emmanuel 10 08 15 8871 W 34 Court / / Hialeah FL 33018 I Manager CHE $50.00 6 Travaglia, Andrea 10 09 15 6431 Pine Tree Drive / / Circle Miami Beach FL 33141 I Retired CHE $1,000.00 7 DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (----p a itpF- 1 z CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Mark Samuelian (1) Name (2) I.D. Number 10 03 15 10 16 15 2 3 (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 Meyers, Jonas 10 09 15 2017 North Bay Road Miami Beach FL 33140 I Retired CHE $1,000.00 8 Levine, Michael 10 09 15 1401 Bay Road Miami Beach FL 33139 I Attorney CHE $50.00 9 Hand, Francinelee 10 10 15 5313 N Bay Road Miami Beach FL 33140 I Retired CHE $100.00 10 Hahne, William 10 10 15 16 Island Avenue Miami Beach FL 33139 I Realtor CHE $100.00 11 Buchanan, Edna 10 10 15 400 West San Marino Drive Miami Beach FL 33139 I Author CHE $100.00 12 Genet, Sol 10 16 15 4310 N Michigan Avenue / / Miami Beach FL 33140 I Attorney CHE $100.00 13 Budwick, Michael 10 16 15 1400 N View Drive Miami Beach FL 33140 I Attorney CHE $118.00 14 DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES (-4-2:2) 3 c742 I 7____ CAMPAIGN TREASURER'S REPORT— ITEMIZED CONTRIBUTIONS Mark Samuelian (1) Name (2) I.D. Number 10 03 15 10 16 15 3 3 (3) Cover Period / / through / / (4) Page of (5) (7) (8) (9) (10) (11) (12) Date Full Name 1 (6) (Last,Suffix,First,Middle) Sequence Street Address& Contributor Contribution In-kind Number City,State,Zip Code Type Occupation Type Description Amendment Amount Levine, Michael 10 16 15 1401 Bay Road / / Miami Beach FL 33139 I Attorney CHE $50.00 15 Carhart Capital, 10 16 15 Management / / 300 71st Street Miami Beach FL 33141 B .Financial CHE 16 Advisor $200.00 Samuelian, Mark 10 16 15 10 Venetian Way / / Miami Beach FL 33139 Private 1 Financial LOA $50,000.00 17 Investor / / / / / / / / DS-DE 13(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ' .- -c,.1....10.: e Li 0-0- I Z--- CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2) I.D. Number 10 03 15 10 16 15 1 7 (3)Cover Period / / through / / (4) Page 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 Jardines, Verena' Campaign Admin 10/ 03/15 200 Alton Road Miami Beach FL 33139 MON $700.00 1 10 / 04 15 Sazon Cuban Cuisine Voter Lunch 7305 Collins Avenue Miami Beach FL 33141 MON $460.41 2 Anedot Cc Processing Fee 10 / 05 15 5555 Hilton Avenue Baton Rouge LA 70808 MON $4.20 3 Publix Drinks for Event 10 05 15 1920 West Avenue Miami Beach FL 33139 MON $126.27 4 Comcast/Spotlight Media Buy 10 / 05 15 1800 NW 49 Street, Ste.140 Ft Lauderdale FL 33309 MON $8,500.00 5 Campaign Statistical Campaign Statistics 10 05 15 1966 NE 123RD Sreet North Miami FL 33161 MON $1,500.00 6 Miami-Dade County Voter Lists 10 05 15 2700 NW 87 Avenue Doral FL 33172 MON $200.00 7 Blueprint Consulting Campaign Admin PO Boc 310561 10 / 05 15 Miami FL 33231 MON $142.38 8 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 1Z___ CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2) I.D. Number 10 03 15 10 16 5 2 7 (3)Cover Period / through / (4) Page of (5) (7) (8) (9) (10) (11) Date Full Name Purpose (s) (Last,Suffix,First,Middle) (add office sought if Sequence Street Address& contribution to a Expenditure Number City,State,Zip Code candidate) Type Amendment Amount Blueprint Consulting Phone Banking 10 /05 //15 PO Box 310561 , Miami FL 33231 MON $439.42 9 10 /05 /15 Blueprint Consulting Event Planning PO Box 310561 Miami FL 33231 MON $574.04 10 Blueprint Consulting Event Planning 10 05 /15 PO Box 310561 Miami FL 33231 MON $581.80 11 Blueprint Consulting Campaign Management 10 05 15 PO Box 310561 Miami FL 33231 MON $2,195.20 12 Milman Research and Consulting Candidate Research 10 /05 /15 14716 Top Sergeant Lane Centreville VA 20121 MON $1,150.00 13 Ferguson, Latricia Phone Banking 10 06 15 5815 NW 12 Avenue Miami FL 33127 MON $25.00 14 Icebox Cafe Campaign Meeting 10 06 15 1855 Purdy Avenue Miami Beach FL 33139 MON $88.58 15 Publix Dessert for Voter 6876 Collins Avenue Event 10 /07 /15 Miami Beach FL 33141 MON $117.69 16 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2) I.D. Number (3)Cover Period 10 /03 /15 through to /16 / 15 (4) Page 3 of 7 (5) (7) (8) (9) (1 0) (1 1) 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 Ricketts, Al Event Photography 10 /07 /15 3820 Garfield Street Hollywood FL 33022 MON $250.00 17 10 8 /15 Anedot Cc Processing Fee 5555 Hilton Avenue Baton Rouge LA 70808 MON $2.25 18 Anedot Cc Processing Fee 10 08 /15 5555 Hilton Avenue Baton Rouge LA 70808 MON $2.25 19 Ferguson, Latricia Phone Banking 10 08 15 5815 NW 12 Avenue / / Miami FL 33127 MON $25.00 20 Vargas, Luis Alberto Entertainment 10 /08 /15 480 NW 135th Steet North Miami FL 33162 MON $150.00 21 Publix Coffee for Phone 10 08 15 1920 West Avenue Bankers / / Miami Beach FL 33139 MON $25.85 22 Fedex Postage 10 08 15 1617 Alton Road Miami Beach FL 33139 MON $9.80 23 Miami Gardens Florist Appreciation Gift 18500 W Dixie Hwy 10 /9 /15 Aventura FL MON $69.54 24 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2) I.D. Number (3)Cover Period 10 /03 ,15 through 10 /16 / 15 (4) Page 4 of 7 (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 National Campaign Resource Group English and 10 /09 /45 11380 Prosperity Farms Road #221E Spanish Mail Pieces Palm Beach Gardens FL 33410 MON $19,466.00 25 Expert Business & Professional Copy Redevelopment 10 /09 /15 Services 9220 Chelsea Drive South Plantation FL 33324 MON $599.00 26 LISPS Postage 10 /09 /15 1661 West Avenue Miami Beach FL 33139 MON $125.10 27 Anedot Cc Processing Fee 10 09 15 5555 Hilton Avenue Baton Rouge LA 70808 MON $39.30 28 Anedot Cc Processing Fee 10 /09 /15 5555 Hilton Avenue Baton Rogue LA 70808 MON $39.30 29 Anedot Cc Processing Fee 10 09' 15 5555 Hilton Avenue Baton Rogue LA 70808 MON $2.25 30 Ferguson, Latricia Phone Banking 10 09 15 5815 NW 12 Avenue Miami FL 33127 MON $50.00 31 Walgreens Voter Pics 1845 Alton Road 10 /11 /15 Miami Beach FL 33139 MON $18.36 32 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ,rte_ e CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2)I.D. Number (3)Cover Period 10 /03 /15 through 10 /16 ,15 (4) Page 5 of 7 (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 F&B for Events 10 /11 /15 1920 West Avenue Miami Beach FL 33139 MON $208.33 33 10 /12 /15 Messer Caparello Legal 2618 Centennial Place Tallahassee FL 32308 MON $315.00 34 Vargas, Luis Alberto Entertainer 10 /12 /15 480 NW 135th Street North Miami FL 33162 MON $150.00 35 Blueprint Consulting Campaign Manager 10 12 15 PO Box 310561 Miami FL 33231 MON $1,200.00 36 Vargas, Linda Phone Banking 10 12 15 480 NW 135th Street North Miami FL 33162 MON $72.00 37 Cafe Avanti Event 10 12 15 732 41st Street Miami Beach FL 33140 MON $282.25 38 Cafe Avanti Beverage at Event 10 12 15 732 41st Street Miami Beach FL 33140 MON $27.89 39 La Voz de Miami Beach Community Newspaper PO Box 140585 10 /15 /15 Coral Gables 33114 MON $500.00 40 DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES E CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2) I.D. Number 10 03 15 10 16 15 6 7 (3) Cover Period / / through / / (4) Page of (5) (7) (8) (9) (1 0) (1 1) 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 Pixabite Tshirts 10 /13 /15 14262 SW 140 St #120 Miami FL 33186 MON $865.14 41 10 13 15 Vargas, Luis Alberto Entertainer / / 480 NW 135th Street North Miami FL 33162 MON $150.00 42 Vargas, Linda Phone Banking 10 /13 /15 480 NW 135th Street North Miami FL 33162 MON $100.00 43 Publix F&B for Events 10 13 15 1045 Dade Boulevard / / Miami Beach FL 33139 MON $73.45 44 Ferguson, Latricia Phone Banking 10 /14 /15 5815 NW 12 Avenue Miami FL 33127 MON $40.00 45 Vargas, Linda Phone Banking 10 14 15 480 NW 135th Street / / North Miami FL 33162 MON $40.00 46 Publix Food for Event 10 15 15 1045 Dade Boulevard Miami Beach FL 33139 MON $97.64 47 National Campaign Resource Group English/Spanish 11380 Prosperity Farms Road #221E Mailers 10 /15 /15 Palm Beach Gardens FL 33410 MON $29,622.00 48 DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES I 0 CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2) I.D. Number 10 ,03 15 10 16 15 7 7 (3)Cover Period / / through / / (4) Page 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 Vargas, Luis Alberto Entertainer 10 /15 //15 480 NW 135th Street North Miami FL 33162 MON $150.00 49 10 15 15 Jardines, Verena Campaign Admin 200 Alton Road Miami Beach FL 33139 MON $700.00 50 Ferguson, Latricia Phone Banking 10 /15 /15 5815 NW 12 Avenue Miami FL 33127 MON $50.00 51 The Sharpton Group Accounting 10 16 15 One SE 3rd Avenue Miami FL 33131 1 MON $5,387.50 52 TLE Analytics Data 10 /16 /15 408 NE 6th Street, Unit 340 Ft Lauderdale FL 33304 MON $900.00 53 Publix F&B for Events 10 16 15 1920 West Avenue Miami am Beach FL 33139 MON $273.62 54 / / / / DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES c HFI2 CAMPAIGN TREASURER'S REPORT- ITEMIZED EXPENDITURES (1) Name Mark Samuelian (2) I.D. Number (3)Cover Period 10 / 03 / 15 through 10 / 16 / 15 (4) Page 1 of (5) (7) (8) (9) (1 0) (1 1) 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 Blueprint Consulting Event Planning 10 it 05/ 15 PO Box 310561 Miami, FL 33231 MON Delete $581.80 11 / / / / / / / / DS-DE 14(Rev.11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 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: Priv Financial Investor OCCUPATION: AMOUNT OF LOAN: 450,Don • ao AMOUNT OF LOAN: DATE RECEIVED: 10/16/2015 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) f z o F (�