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DS-DE 12 Campaign Treasurer's Report F1-07 SalomFLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) LUIS SALOM OFFICE USE ONLY Name (2) 815 NORTH SHORE DRIVE _ =-~ ~' Address (number and street) ~ N '" ~ ~-~ r-*i ~'o' MIAMI BEACH, FLORIDA 33141 ; ~ -'~ -~ City, State, Zip Code N ~ - ~ ~~ ^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: ~ 0~)00..~ (4) Check appropriate box(es): ~ N ~~ ^/ Candidate (office sought): MIAMI BEACH COMMISSON GROUP IV ^ Political Committee ^ CHECK IF PC HAS DISBANDED ^ Committee of Continuous Existence ^ CHECK IF CCE HAS DISBANDED ^ Party Executive Committee ^ Electioneering Communication ^ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From o~ / of / o~ To 09 / 14 / o~ Report Type F1 - o~ Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 17 , 5 0 0.0 0 Expenditures $ 5 2 , 7 9 2 .4 3 Loans $ _ Transfers to Office Account $ Total Monetary $ 17 , 5 0 0.0 0 Total Monetary $ 52, 792.43 In-Kind $ 2, 000.00 (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 184,523.10 $ 88,879.77 (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, I certify that I have examined this report and it is true, correct, and complete. correct, and complete. (type name GLORIA SALOM (Type name) LUIS SALOM ^Indivi o o ~Tre surer ^/ Deputy Treasurer Q Candi hai erson (only for PC, PTY & electione g n.) electi Bring ommun. organization) X Signature Signa re nc_nF ~ ~ ~Ro., naind~ ~Q~ ~_. ~ ©F l i CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name LUIS SALOM (2) I.D. Number (3) Cover Period o7 / of / 07 through o9 / 14 / 07 (4) Page 00000 Z- of 11 (5) (~) (8) (9) (10) (~~) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit ,State, Zi Code T e Occu ation T e Descri tion Amendment Amount Pharmed Group B Med CHE 500.00 07 02 07 3075 NW 107th Av Equip ~ X Miami FL 33172 , 00367 Richard Kresch, I Doctor CHE 500.00 07 ~ 02 ~ 07 MD 34 Stilles Lane Greenwich, CT 00368 06831 New World B Broadcas CHE 500.00 07 02 07 Broadcasting ting ~ ~ 9415 SW 144th St Miami, FL 33176 00369 ASR Interiors B Interior CHE 500.00 07 07 02 42202 Fisher Isl Design ~ ~ Fisher Island 33109 00370 D&D Management B Mgmt CHE 500.00 07 ~ 02 ~ 07 Corp. 42202 Fi h I l d D s er an r s Fisher Island 00371 33109 ASR Const. B Construc CHE __ - - __ 500.00 07 07 02 42202 Fisher tion ~ / Island Dr Fisher Island 00372 33109 ASR, LLC B Consulti CHE 500.00 07 02 07 42202 Fisher ng ~ ~ Island Dr 00373 Fisher Island 33109 Robert Borges I Media CHE 100.00 07 02 07 6940 Hemingway ~ ~ Court S n a Diego, CA 92120 00374 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 2 0~ 11 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name LUIS SALOM (2) I.D. Number 00000 (3) Cover Period ° 7 / o l / ° 7 through o 9 / 14 / 0 7 (4) Page ~ of ( I (5) (~) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Ci ,State, Zi Code T e Occu ation T e Descri tion Amendment Amount Raj Gohill I DDS CHE 250.00 12 07 07 975 Arthur Godfrey ~ X Rd Miami Beach , FL 33140 00375 Sydney Carpel I Director CHE 50.00 07 ~ 31 ~ 07 8601 S.W. 80 Ct Miami, FL 33143 00376 Carlos Pena 40 I Business CHE 150.00 08 ~ 04 ` 07 NE 1st Av man Miami FL 33132 , 00377 Cafe Avanti 732 B Restaura INK FOOD ~ ~~. 500.00 08 Z1 07 41st Street Miami nt ~ ~ Be h FL 33140 , ac 00378 RH Hansford & Co B Investme CHE 250.00 08 ~ 23 ~ 07 5632 La Gorce Dr Mi i B h F nt am eac , L 33141 00379 RH Hansford & Co B Investme CHE 250.00 08 23 07 5632 La Gorce Dr nt ~ ~ Miami Beach FL , 33141 00380 Deysi Falcon 660 I Business CHE 250.00 08 23 07 SW 57 Ave Miami, woman ~ ~ FL 33144 00381 Anthony Garcia I Financia CHE 500.00 08 23 07 255 W.33 Street 1 / ~ Miami Beach FL Advisor , 33140 00382 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~ a~ 1l CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name LUIS SALOM (2) I.D. Number (3) Cover Period 07 / of / 07 through o9 / 14 / 07 (4) Page 00000 ~ of 11 (5) (7) (8) (9) (10) (11) (12) . Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Ci ,State, Zi Code T Occu ation T e Descri lion Amendment Amount Ben Wagman 2408 I Restaran CHE 500.00 08 27 07 NE 22 Terr Ft. teur ~ X FL Lauderdale , 33305 00383 Heafey Bentley B Mgmt CHE 500.00 08 ~ 28 ~ 07 Mgmt. 101 Ocean i ami Beach, Drive M FL 33139 00384 Vivi Restaurant B Rest INK ~ooD d aeu• 500.00 p7 08 27 101 Ocean Drive ~ ~ FL Miami Beach , 33139 00385 PH Hotel, Inc. B Hotel CHE 500.00 08 ~ 28 ` 07 1717 N. Bayshore e Miami Dri FL , v 33132 00386 PH Retail 1717 B Retail CHE 500.00 08 ~ 28 ~ 07 Bayshore Dr i i FL 33132 M am , 00387 510 Ocean Dr. LLC B Real CHE _ - __ 500.00 08 07 28 1717 Bayshore Dr Estate ~ r Miami Beach FL , 33132 00388 Heafey-Bentley B Hotel CHE 500.00 08 28 07 Hotel 1717 ~ ~ a shore Dr Miami y , 00389 FL 33132 PH Bentley Bay B Mgmt CHE 500.00 08 28 07 1717 Bayshore Dr / ~ Miami FL 33132 00390 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES '-{ o F l1 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name LUIS SALOM (2) I.D. Number 00000 (3) Cover Period 07 / 01 / 07 through o9 / 14 / 07 (4) Page '.~ of i t (5) (~) (8) (9) (~ 0) (~ ~ ) (~ 2) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit ,State, Zi Code T e Occu ation T e Descri tion Amendment Amount Gino Falsetto I Investor CHE 500.00 28 07 08 1717 Bayshore Dr X ~ FL 33132 Miami , 00391 Bantley Boys LLC B Investme CHE 500.00 08 ~ 28 ~ 07 1717 Bayshore Dr i i nt , FL 33132 M am 00392 Aries Management B Mgmt CHE 500.00 08 28 p7 1717 Bayshore Dr ~ ~ Miami FL 33132 , 00393 Double Park LLC B Mgmt CHE 500.00 08 07 28 1717 Bayshore Dr ~ ~ FL 33132 Mi mi a , 00394 Margie Godoy 410 I Realtor CHE 250.00 08 ~ 28 ~ 07 Marmore Ave Coral FL 33146 G bl es, a 00395 Armando's Service B Serv. CHE 250.00 08 28 07 Station 6348 Station ~ ~ Collins Ave Miami Beach, FL 33141 00396 Elizabeth I Atty CHE 150.00 08 28 07 Schwartz 560 ~ ~ Lincoln Rd Miami 00397 Beach, FL 33139 M Cassidy I Artist CHE 500.00 08 28 07 7701 Collins Av , ~ Miami Beach FL , 33141 00398 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES S ~F ~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name LUIS SALOM (2) I.D. Number (3) Cover Period o7 / 01 / 07 through o9 / 14 / 07 (4) Page 00000 ~ of rt (5) (~) (8) (9) (10) (~~) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Cit ,State, Zi Code T e Occu ation T e Descri tion Amendment Amount Lorena Gomez 871 I Business CHE 500.00 08 28 07 N. Venetian Dr woman ~ X Miami Beach FL , 33139 00399 Evelio Gomez 871 I Business CHE 500.00 08 ~ 28 ~ 07 N. Venetian Dr man Miami Beach, FL 33139 00400 Prime 112, LLC B Restaura CHE 500.00 07 08 29 112 Ocean Dr nt ~ ~ Miami Beach FL , 33139 00401 Lara Saieh 433 I Homemake CHE 100.00 09 07 07 E. Dilido Dr Miami r ~ ~ FL 33139 B a h e c , 00402 Erik Fresen I Business CHE 500.00 09 ~ 07 ~ 07 1740 SW 64 Av FL 33155 Mi i man am , 00403 Ignacio Zulueta I Business CHE 500.00 09 07 07 6255 Bird Rd man ~ ~ Miami FL 33155 , 00404 Victor Da Yurre, B Atty CHE 100.00 09 07 07 Atty at Law 1000 ~ ~ rickell Av Miami , 00405 FL 33131 Norman Levine 901 I CPA CHE 200.00 09 07 07 NE 125 St. North ~ ~ Miami FL 33161 , 00406 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~ ~~ (~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name LU25 SALOM (2) I.D. Number (3) Cover Period o 7 / o l / 0 7 through o 9 / 14 / 0 7 (4) Page 00000 '~ of II (5) (7) (8) (9) (10) (11) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number Ci ,State, Zi Code T e Occu ation T e Descri tion Amendment Amount Touch Restaurant B Restaura INK Food & Bev. 500.00 07 09 06 910 Lincoln Rd nt / 1 Miami Beach FL , 33139 00407 Civica, LLC B Mgmt CHE 500.00 09 1 07 / 07 8323 NW 12 St Doral, FL 33126 00408 Prime Mortgage B Mtg Co CHE 250.00 09 09 07 Solutions 1101 1 / Brickell Av Miami, FL 33131 00409 The Balcera B Communic CHE 500.00 09 07 13 Communications ations / / 3663 SW 8th St Miami, FL 33135 00410 ~ Leon A. Manne I Retired CHE 100.00 09 13 07 5500 Collins Av 1 / FL Mi i B h am eac , 33140 00411 iami Firefighters B Firefigh CHE 500.00 09 07 13 pAC 2980 NW S ters 1 1 River Dr Mami FL , 33125 00412 Ohfeo Realty B Realty CHE 500.00 09 13 07 760 Ocean Dr 1 / Miami Beach FL , 00413 33139 Al Feola 760 I Business CHE 250.00 09 13 07 Ocean Dr Miami man 1 1 Beach FL 33139 , 00414 DS-DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~ .~~. ~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name LUIS SALOM (2) I.D. Number 00000 (3) Cover Period 07 / of / 07 through o9 / 14 / 07 (4) Page ~ of it (5) Date (7) Full Name (8) (9) (10) (11) (12) (6) Sequence Number (Last, Suffix, First, Middle) Street Address & Cit ,State, Zi Code Contributor T e Occu ation Contribution T e In-kind Descri tion Amendment Amount 08 ~ 21 X07 Luis Fuentes 732 41st St Miami Beach FL 33140 I Business man INK Food & Bev. 500.00 00415 , 09 ~ 14 ~ 07 Benita Argon 1345 West Ave I Sec. CHE 50.00 00416 Miami Beach, FL 33139 / / / I / / / / / / / / DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~ ~ ~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name_ Luls sALOM (2) I.D. Number_ 00000 (3) Cover Period o7 / 01 / 07 through 09 / 14 / 07 (4) Page ~ of 11 (5) (7) (8) (9) (1 0) (11) Date Full Name Purpose (8) (Last, Suffix, First, Middle) (add office sought if Sequence Street Address & contribution to a Expenditure Number City, State, Zip Code candidate) TYPe Amendment Amount Albert Valera Staff MON 253.50 07 (06 /07 ?827 SW 143rd St Miami, - FL 33175 1048 Garber & Goodman 300 41st Consulting MON 1,698.32 07 6 7 Street Miami Beach, FL 33140 1049 Penta Communications Consulting MON 6,803.00 07 13 07 1982 NE 147th Terr., N. Miami, FL 33181 1050 Albert Valera 2827 Staff MON 200.00 07 13 07 SW 143rd Street Miami, FL 33175 1051 Garber & Goodman 300 Consulting MON 1,900.00 07 16 07 41st Street Miami Beach, FL 33140 1052 Herb Sosa 829 Adv. MON 600.00 07 25 07 9th Street Miami Beach, FL 33139 1053 Office Depot 12190 Supplies MON 78.72 07 26 07 Biscayne Blv N. Miami FL 33161 , 1054 Luis Salom 815 Payback Loan MON 25,000.00 07 27 07 N. Shore Dr. Miami Beach, FL 33141 1055 DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ OF (1 CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name _ Luzs SALOM (2) I.D. Number _ (3) Cover Period o 7 ~ O 1 ~ ~ 7 through ~ 9 / 14 / ~ ~ _ (4) Page ~ 6 00000 of ti (5) (~) ($) (9) (~o) (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 Albert Valera 2827 SW Staff MON 200.00 07 r27 /07 143rd Street Miami, FL 33175 1056 Che Miami Herald 1 Herald Ad MON 4,660.00 07 8 7 Plaza Miami, FL 33132 1057 MV Almer Production 1541 Consultation MON 2,000.00 08 O1 07 3rickell Ave Unit C606 Miami, FL 33129 1058 MV Almer Productions 1541 Promotion MON 875.00 08 O1 07 Brickell Ave #C606 Miami, FL 33129 1059 Genny De Bernardo 1210 E Adv MON 300.00 08 16 07 8th Ave Hialeah, FL 33010 1060 Albert Valera 2827 SW Staff MON 600.00 08 17 07 143rd Street Miami, FL 33175 1061 Albert Valera 2827 SW Staff MON 301.65 08 24 07 143rd Street Miami, FL 33175 1062 Garber & Goodman 300 41st Consulting MON 1,900.00 08 30 07 Street Miami Beach, FL 33140 1063 DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 10 a~ \~ CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name_ Luzs sALOM (2) I.D. Number_ 00000 (3) Cover Period 07 ~ O 1 ~ 07 through _ 09 14 ~ 07 (4) Page __ 1d _ of ~ ~ (5) Date (7) Full Name (8) Purpose (9) (10) (11) (s) Sequence Number (Last, Suffix, First, Middle) Street Address 8: City, State, Zip Code (add office sought if contribution to a candidate) Expenditure Type Amendment Amount 09 ~05 /07 1064 Post It, Inc. 1480 NE 129th Street N. Miami, FL 33161 Adv. MON 3,737.24 09 5 7 MV Almer Productions 1541 Brickell Av #C606 Miami, FL 33129 Promotion MON 665.00 1065 09 06 07 City of Miami Beach 1700 Convention Center Dr Miami Beach, FL 33139 Qualifying Fee MON 1,020.00 1066 OS-DE 14 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES i ~ OF ~ t