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DS-DE 12 Góngora F4-09~'~ lo- ~0-ao0~ FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Michael Gongora OFFICE USE ONLY Name (2) 5838 Collins Av. #3A Address (number and street) Miami Beach, FL 33140 City, State, Zip Code ^ CHECK IF ADDRESS HAS CHANGED (3) ID Number: 0 0 0 0 0 (4) Check appropriate box(es): © Candidate (office sought): Miami Beach Commission, Group 3 ^ 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 10 / 10 / 09 To 10 / 29 / 09 Report Type F4-09 ~ Original ^ Amendment ^ Special Election Report ^ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT (7) EXPENDITURES THIS REPORT Monetary Cash & Checks $ 2 4, 8 2 5. 0 0 Expenditures $ 2 6, 2 0 2 .2 7 Loans $ Transfers to Office Account $ Total Monetary $ 2 4, 8 2 5 .0 0 Total Monetary $ 26, 202 .27 In-Kind $ (8) Other Distributions (9) TOTAL Monetary Contributions To Date (10) TOTAL Monetary Expenditures To Date $ 123,795.00 $ 53,022.55 (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, 1 certify that I have examined this report and it is true, correct, and complete. correct, and complete. (Type name) Michael Gongora (Type name) Michael Gongora ^ Individual (only for ®Treasurer ^ Deputy Treasurer ©Candidate ^ Chairperson (only for PC. PTY & electio eeri commun.) elecC veering commun. organization) X ~ X Signature Signature DS-DE 12 (Rev. 08/04) O~ I ~ ~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number (3) Cover Period 10 / 10 / 0 9 through 10 / 2 9 / 0 9 (4) Page 00000 2 of (5) (~) (8) (9) (10) (~~) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address $ Contributor Contribution In-kind Number C' State Zi Code T Occu anon T e Descri tion /+mendmern Amount Douglas Houghton I Business Credit $120 10 / 10 /09 4250 N. Michigan man Card Av. Miami Beach, FL 1 33140 Stephen Cypen I Attorney Credit $500 10 / 16 / 09 777 Arthur Godfrey Card Rd. 2 #320 Miami Beach, FL 3 Adrian Barzola I Market Credit $100 1~ / 2 d / 09p 5775 Collins Av. ing Card #901 Miami Beach, FL 3 33140 George R. Wallner I Business Che $500 10 / 2 ~ / 09 17 N. Hibiscus Dr. man Miami Beach, FL 33139 4 Dadeland Depot, B Business Che $500 10 / 23 / 09 Inc. - 2665 S. Bayshore Depot 5 Dr. Coconut Grove, FL 33133 Berkowitz B Develop Che $500 10 / 23 / 09 Development Group, ment Inc. 6 2665 South S. Bayshore Dr. Coconut Grove, F~ Envision USA Inc. B Business Che $500 10 / 23 / 09 1717 N. Bayshore Dr. 7 Miami, FL 33132 L. Pathman I Business Che $500 10 / 23 / 09 72 S. Hibiscus Dr. man Miami Beach, FL 8 33139 u~-u~ 73 (ReV. vS/o3) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ ~ ~9 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 0 9 through 10 / 2 9 / 09 (4) Page 3 of (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 Jim Cavanaugh I Real Che 500 10 / 23 /09 35 N. Hibiscus Estate Dr. Miami Beach, FL 9 33139 Committee Without B PAC Che 500 10 / 23 / 09 an Agenda 7455 Collins Av. 10 #212 Miami Beach, FL 33141 Two by Two B Enter Che 500 10 / 23 / 09 1057 Washington tain Av. ment Miami Beach, FL 11 33139 Joel David Stedman I Business Che 500 10 / 23 / 09 1800 Purdy Av. man #2101 Miami Beach, FL 12 33139 Richard Trainor I Business Che 500 10 / 23 / 09 1840 Cleveland Rd. man Miami Beach, FL 33141 13 Tracy Austin I Manager Che 500 10 / 23 / 09 923 9th Av. SW Rochester, MN 14 55902 SEIU FL State B PAC Che 500 10 / 23 / 09 Council CCE 14645 NW 77th Av, 15 #201 Miami Lakes, FL 33014 O SEIU FL Healthcare B PAC Che 500 10 / 23 / 09 Union CCE 14645 NW 77th Av. #201 16 Miami Lakes, FL 33014 p DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES io~ ~ /~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Mi chae 1 Gongora (2) I.D. Number 0 0 0 0 0 (3) Cover Period to / to / 09 through to / 29 / 09 (4) Page 4 of (5) (~) (8) (9) (~~) (~~) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number C' State Zi Code T Occu ation T e Descri tion ,nmenament Amount US Fidelity Title B Title Che $300 10 ~ 23 X09 Co. Co. 1441 Brickell Av. #1430 17 Miami, FL 33131 Robert Keith Gray I Investor Che $250 10 ~ 23 ~ 09 6001 Pine Tree Dr. Miami Beach, FL 18 33140 James B. Kerwin I Business Che $250 l~ / 2~ / 09p 6301 Collins Av. man Miami Beach, FL 33141 19 David H. Young, I Attorney Che $250 10 ~ 2 ~ ~ 09 Esq. 617 Sabal Palm Rd. Miami, FL 33137 20 Babak Movahedi I Business Che $250 10 ~ 23 ~ 09 1000 West Av. man #TS-3 Miami Beach, FL 21 33139 Imad W. Kemp I Investor Che 200 10 ~ 23 ~ 09 1775 Jefferson Av. Miami Beach, FL 22 33139 Mark D. Balzli I Attorney Che 100 10 ~ 23 ~ 09 2383 N. Bay Rd. Miami Beach, FL 23 33140 Daniel B. Markson I Investor Che 100 10 ~ 2g / 09 2421 Lake Pancoast Dr. #4C Miami Beach, FL 24 33140 D5-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ,~~~~rQ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) LD. Number 00000 (3) Cover Period to / to / 09 through 10 / 29 / 09 (4) Page 5 of (5) (7) (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 lion Amendment Amount Deborah Markham I Hospital Che $100 10 / 23 /09 Ruggiero ity 7356 Gary Av. Miami Beach, FL 25 33141 Joy V.W. Malakoff I Banker Che $100 10 / 23 / 09 6415 Pine Tree Dr. Miami Beach, FL 26 33141 Territory Inc. B Che $100 ld / 2 ~ / 09p 710 Washington Av. Miami Beach, FL 33139 27 Harry Gurwitch I Che $50 10 / 2 ~ / 09 2525 Sunset Dr. Miami Beach, FL 33140 28 Carol M. Hoffman I Che $50 10 / 23 / 09 4740 Alton Rd. Miami Beach, FL 29 33140 Ray E. Breslin I Business Che 50 10 / 23 / 09 2395 Lake Pancoast man Dr. #4 30 Miami Beach, FL 33140 Ruth E. Heuman I Che 25 10 / 23 / 09 1225 West Ave. Apt. 501 31 Miami Beach, FL 33139 Aurora Esteves, I Che 25 10 / 23 / 09 P.A. 145 SW 25th Rd. 32 #601 Miami, FL 33129 D5-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES D~5~r9 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period i o / i o / 0 9 through i o / 2 9 / 0 9 (4) Page 6 of (5) (~) (8) (9) (10) (~~) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address 8 Contributor Contribution In-kind Number C' State Zi Code T Occu ation T e Descri tion ~~~ Amount Michael Robert I Che $100 10 / 23 /09 Buckner 232 Mott Street PH 33 New York, NY 10012 Edward E. Straub, I Che $50 10 / 23 / 09 Jr. 20 Island Av., 34 #1509 Miami Beach, FL Elizabeth Calderon I Che $25 1 / 2~ / 09~ 9417 Bay Drive Surfside, FL 33154 35 Ruth Wallner I Business Che $500 10 / 2 ~ / 09 17 N. Hibiscus Dr. woman Miami Beach, FL 33139 36 Fred Sherman I Credit $10 10 / 23 / 09 1133 - 15th St., Card NW #350 Washington, D.C. 37 20005 Vivian Roiz I Investor Che $500 10 / 23 / 09 4925 Collins Av. #6C 38 Miami Beach, FL 33140 Carmen O. Velasco I Investor Che $500 10 / 23 / 09 4925 Collins Av. #6C 39 Miami Beach, FL 33140 2K Clevelander, B Hotel Che $500 10 / 23 / O9 LLC 1020 Ocean Drive Miami, FL 33139 40 D5-DE 13 (Rev. 08103) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~,~ ~ ~ /9 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period to / 10 / 09 through to / 29 / 09 (4) Page 7 of (5) (~) (8) (9) (10) (~~) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number C' State Zi Code T Occu anon T e Descri tion ~~~ Amount 2K Essex LLC B Real Che $500 10 / 23 /09 1001 Collins Av. Estate Miami Beach, FL 33139 41 T. Gene Prescott I Investor Che $250 10 / 23 / 09 1200 Anastasia Av. Coral Gables, FL 42 33134 Jessica Srebnick I Business Che $250 ld / 2~ / 09p 6686 Roxbury Ln. woman Miami Beach, FL 33141 43 Eric Stackman I Che ;I50 10 / 2 ~ / 09 7513 W. Treasure Dr. N. Bay Village, FL 44 33141 Brian Levin I Che $100 10 / 23 / 09 6801 Indian Creek Dr. #501 Miami Beach, FL 45 33141 Scott Wagner i Che $100 10 / 23 / 09 4717 Alton Rd. Miami Beach, FL 46 33140 The Ride B Business Che $100 10 / 23 / 09 Experience, LLC 1250 S. Miami Av. 47 #1408 Miami, FL 33130 Dimond Kaplan & B Law Firm Che $100 10 / 23 / 09 Rrothstein, P.A. 2655 S. Bayshore 48 Dr. Miami, FL 33133 D5-DE 73 (ReV. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES n~ ~ ~ ~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 0 0 0 0 0 (3) Cover PeMod to / to / 09 through to / 29 / 09 (4) Page 8 of (5) (~) (8) (9) (10) (~~) (12) Date Full Name (6) (Last, Suffix, First, Middle) Sequence Street Address & Contributor Contribution In-kind Number C' State Zi Code T e Occu ation T e Descri tion ~ndment Amount Donald Kipnis I Che $75 10 ~ 23 X09 2333 Brickell Av. Terrace C Miami, FL 33129 49 Layout Completion, B Business Che $75 10 ~ 23 ~ 09 Inc. Layouts 3570 NTW 73rd Av. 50 Lauderhill, FL 33319 Sylvie Digenova I Che $75 ld / 2~ / 09p 3570 NW 73rd Av. Lauderhill, FL 33319 51 Matthew Sarelson I Che $50 10 ~ 2 ~ ~ 09 2001 Meridian Av. #PH-15 Miami, FL 33139 52 Marc Meran I Che $50 10 ~ 23 ~ 09 1508 Bay Rd. Apt. 1221 Miami Beach, FL 53 33139 Jonathan Feldman I Che $50 10 ~ 23 ~ 09 526 - 15th St. #5 Miami Beach, FL 54 33139 Adam Sendzischew I Che $50 10 ~ 23 ~ 09 151 Michigan Ave. #535 55 Miami Beach, FL 33139 Gregory Deutch I Che $50 10 ~ 23 ~ 09 401 Ocean Dr. #1123 Miami Beach, FL 56 33139 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ ~ `~~ 1~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 09 through 10 / 29 / 09 (4) Page 9 of (5) (~) ($) (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 Chisholm B Real Che 500 10 / 29 /09 Properties South Estate Beach 1717 Collins Av. 57 Miami Beach, FL Florida Fire-PAC B PAC Che 500 10 / 29 / 09 345 W. Madison St. Tallahassee, FL 58 32301 Alton XV, Corp. B Real Che 500 10 / 29 / 09 523 Michigan Av. Estate Miami Beach, FL 33139 59 Kendall I Plaza B Real Che 500 10 / 29 / 09 Ltd. Estate 523 Michigan Av. Miami Beach, FL 60 33139 Debra Reyes I Banker Che 500. 10 / 29 / 09 6211 S. Macdill Ave. Unit 3 Tampa, FL 33611 61 Leonard A. Wien B Trust Che 500 10 / 29 / 09 Jr. Rev. Trust 333 41st St. 62 Miami Beach, F1 33140 Simon Cruz I Banker Che 250 10 / 29 / 09 5828 Pine Tree Drive 63 Miami Beach, FL 33140 Stratton & B Law Firm Che 100 10 / 29 / 09 Feinstein, P.A. 407 Lincoln Rd. #2A 64 Miami Beach, FL 33139 p DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES Q ~'~ ~ '~ ~ l CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 09 through 10 / 29 / 09 (4) Page 10 of (5) (7) (8) (9) (10) (11) (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 Oceans End LLC B Rest Che 100 10 / 29 /09 1501 Collins Av. aurant #112 Miami Beach, FL 65 33139 Compass Cafe, Inc. B Restau Che 100 10 / 29 / 09 860 Ocean Dr. rant Miami Beach, FL 66 33139 1906 Collins LLC B Restau Che 100 10 / 29 / 09 dba Vita rant Restaurant & Lounge 67 1906 Collins Av. Miami Beach, FL p Kenneth Barilich I Che 100 10 / 29 / 09 921 NE 72nd St. Miami, FL 33138 68 Steven Polisar I Attorney Che 100 10 / 29 / 09 407 Lincoln Rd. #2A Miami Beach, FL 69 33139 Daniel Sehres I Business Che 100 10 / 29 / 09 1545 Meridian Ave. man Miami Beach, FL 70 33139 Fat & Fat, LLC B Che 100 10 / 29 / 09 2701 Collins Ave. Miami Beach, FL 71 33140 EJ Collins LLC B Che 100 10 / 29 / 09 650 West Av. #2906 Miami Beach,FL 33139 72 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES /~~ / D ~ ~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 09 through 10 / 29 / 09 (4) Page 11 of (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 Sylvano Inc. B Che 100 10 / 29 /09 820 Alton Rd. Miami Beach, FL 33139 73 1801 Purdy, LLC B Che 100 10 / 29 / 09 dba Sardinia Enoteca Ristorante 74 1801 Purdy Av. Miami Beach, FL 3 139 Burger & Beer B Che 100 10 / 29 / 09 Joint, LLC 1766 Bay Road Miami Beach, FL 75 33139 Alejandro S. Maya I Che 100 10 / 29 / 09 1000 West Av. #725 Miami Beach, FL 33139 76 Togmiami, LLC B Che 100 10 / 29 / 09 690 Lincoln Rd. #201 Miami Beach, FL 77 33139 Stanley Foodman I Business Che 250 10 / 29 / 09 1201 Brickell Av. man #601 78 Miami, FL 33131 Perry Adair I Credit 100 10 / 29 / 09 9425 SW 93rd Ct. Card Miami, FL 33176 79 Michael Capponi I Business Credit 500 10 / 29 / 09 1835 Purdy Av. man Card Miami Beach, FL 33139 80 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~~ ~ i CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 09 through 10 / 29 / 09 (4) Page 12 of (5) (7) (8) (9) (10) (11) (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 Keith Poliakoff I Attorney Credit 150 10 / 29 /09 3181 N. 36th St. Card Hollywood, FL 33021 81 Scott Marcus I Credit 30 10 / 29 / 09 121 Alhambra Plz. Card 10th FL 82 Coral Gables, FL 33134 Carlos Martin I Credit 90 10 / 29 / 09 121 Alhambra Plz. Card 10th FL Coral Gables, FL 83 33134 Susan Greene I Credit 50 10 / 29 / 09 Heichen Card 1533 NW 178th Way Pembroke Pines, FL 84 33027 Tralfamadore, LLC B Invest Che 500 10 / 29 / 09 160 Greentree Dr. ments #101 Dover, DE 19904 85 Patricia Honings I Business Che 500 10 / 29 / 09 5824 S. Nashville woman Chicago, IL 86 Franklyn I Investor Che 500 10 / 29 / 09 Prednergast 9898 Thunderbluff 87 Rd. NW Oronoco, MN 55960 Brenda Cognac I Environ Che 500 10 / 29 / 09 39065 N. Jackson mental Dr. Services Spring Grove, IL 88 60081 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ ~~ ~ ~9 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 09 through to / 29 / 09 (4) Page 13 of (5) (~) (8) (9) (~~) (~~) (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 Southeast B Consul Che 500 10 ~ 29 X09 Political & ting Campaign Consulting, Inc. 89 1504 Mayo St. Hollywood, FL p Julie Bercow I Investor Che 500 10 ~ 29 ~ 09 590 Lakeview Dr. Miami Beach, FL 90 33140 LBL Group, LLC B Invest Che 250 10 / 29 / 09 125 Jefferson Av., ments #119 Miami Beach, FL 91 33139 Stephen Hertz I Attorney Che 250 10 ~ 29 ~ 09 767 Arthur Godfrey Rd., Miami Beach, FL 92 33140 Ronald Kohn I Business Che 250 10 ~ 29 ~ 09 3580 Palmetto Av. man Miami, FL 33133 93 Mercedes Services B Auto Che 150 10 ~ 29 ~ 09© Inc. Services 14230 NE 18th Av. 94 North Miami Beach, FL 33181 GDB Miami, Inc. B Invest Che 250 10 ~ 29 ~ 09 150 SW 2nd Av. ments #1301 95 Miami, FL 33131 Carol Kahn Trust B Trust Che 50 10 ~ 29 / 09 1730 W. 25th St. Sunset Island #2 Miami Beach, FL 96 33140 DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ ~~~19 CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 09 through 10 / 2 9 / 09 (4) Page 14 of (5) (7) (8) (9) (10) (11) (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 David Evensky I Finan Che 100 10 ~ 29 X09 2323 Ponce De Leon cial PH 1100 Services Coral Gables, FL 97 33134 Miguel Diaz De La I Attorney Che 500 10 ~ 29 ~ 09 portilla 121 Alhambra Plz. 98 Coral Gables, FL 33134 Imperial Group B Security Che 100 10 / 29 / O9 Security Services, Services LLC 309 23rd St. #205 99 Miami Beach, FL 33139 p Gonzalez Holdings B Invest Che 100 10 ~ 29 ~ 09 & Investments ments 3411 SW 21st St. Miami, FL 33145 100 Marina Plumbing B Plumbing Che 100 10 ~ 29 ~ 09 Services Corp. 3361 NW 67th St. Miami, FL 33147 101 Pedro Garcia I Che 100 10 ~ 29 ~ 09 Menocal, Jr. 2927 Center St. 102 Miami, FL 33133 William Hahne I Che 50 10 ~ 29 ~ 09 16 Island Av. #4A Miami Beach, FL 103 33139 Charles Reyes I Che 100 10 ~ 29 ~ 09 6211 S. Macdill Ave. #3 Tampa, FL 33611 104 DS-DE 73 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES 0~ ~ ~ ~ ~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED CONTRIBUTIONS (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 / 09 through 10 / 2 9 / 09 (4) Page 15 of (5) Date (~) Full Name ($) (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 10 ~ 29 X09 Harold M. Unger, M.D. I M.D. Che 25 105 4302 Alton Rd., #720 Miami Beach, FL 33140 p 10 ~ 29 ~ 09 Frank Medina & Associates Inc. B Che 100 106 8004 NW 154th St. #418 Miami Lakes, FL 33016 / / / / / / / / / / / / DS-DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ®~ ~~' ~ ~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 ~ to ~ 09 through to ~ 29 ~ 09 (4) Page 1 of (5) (~) (8) (9) (10) (11) Date Fuii Name Purpose (8) Sequence Number (Last, Suffix, First, Middle) Street Address l~ City, State, Zip Code (add office sought ff conMbution to a candidate) Expenditure Type Amendment Amount Post It, Inc. Mailers MON $267.50 10 14 09 1480 NE 129 St. Miami, FL 33161 1 U.S.P.S. Postage MON $767.89 10 14 09 1455 NW 107th Av. #106 Mi i FL 33172 am , 2 Comcast / Spotlight Cable TV MON $3,608.25 10 16 09 12000 Biscayne Blvd. i i M am , FL 3 Comcast / Spotlight Cable TV MON $940.10 10 16 09 12000 Biscayne Blvd. Miami, FL 4 M.V. Almer Productions, Inc. Events MON $500.00 10 16 09 1541 Brickell Av. No. C606 Mi i FL 33129 am , 5 Post It, Inc. Mailers MON $285.10 10 22 09 1480 NE 129 St. Miami, FL 33161 6 10 2 09 Post It, Inc. 1480 NE 129 St. Mailers MON $546.93 Miami, FL 33161 7 10 22 09 Print Farm 3511 NW 74th Av. Printing MON $604.55 Miami FL 33122 , 8 DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ ~~ ~~~ CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name Michael Gongora (2) I.D. Number (3) Cover Period 10 ~ 10 ~ 09 through 10 ~ 29 ~ 09 (4) Page 2 00000 of (5) (~) ($) (9) (1 0) (11) Date Full Name Purpose (8) 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 U.S.P.S. Postage MON $1,639.85 10 22 09 1455 NW 107th Av. #106 Miami, FL 33172 9 The Lead Miami Beach Advertising MON $895.00 10 29 09 1521 Alton Rd. #115 FL 33139 Miami Beach , 10 5th and Ocean Productions Advertising MON $500.00 10 29 09 1602 Alton Rd. #414 i B h FL 33139 Mi , am eac 11 The Wire Advertising MON $610.00 10 29 O9 1541 Brickell Av. B2004 FL 33129 Mi i am , 12 Washington Square Partners, Graphic Design MON $2,625.00 10 29 09 Inc. ' 16 Island Av #1-D . Miami Beach, FL 33139 13 Washington Square Partners Commission MON $300.75 10 29 09 Inc. 16 l d #1 Is an Av. -D Miami Beach, FL 33139 14 Washington Square Partners Commission MON $739.65 10 9 09 Inc. 16 Island Av. #1-D Miami Beach, FL 33139 15 Washington Square Partners Commission MON $417.75 10 29 09 Inc. 16 Island Av #1-D . Miami Beach, FL 33139 16 DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES ~~ l~ ~r~ CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name Michael Gongora (2) I.D. Number (3) Cover Period 10 ~ 1o j 09 through 10 ~ 29 ~ 09 (4) Page 3 of (5) (7) (8) (S) (10) (~~) Date Full Name Purpose (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 Print Farm Printing MON $1,096.10 10 29 09 3511 NW 74th Av. Miami, FL 33122 17 Print Farm Printing MON $1,096.10 10 29 09 3511 NW 74th Av. Mi i FL 33122 am , 18 Print Farm Printing MON $561.75 10 29 09 3511 NW 74th Av. Mi i FL 33122 am , 19 Print Farm Printing MON $1,639.85 10 29 09 3511 NW 74th Av. i i 33122 M am , FL 20 Post It, Inca Mailers MON $595.08 10 29 09 1480 NE 129 St. Miami FL 33161 , 21 Post It, Inc. Mailers MON $499.10 10 29 09 1480 NE 129 St. i i 33161 M am , FL 22 10 9 09 Washington Square Partners, Inc. Commission MON $528.38 16 Island Av. #1-D Miami Beach, FL 33139 23 Washington Square Partners, Commission MON $802.65 10 29 09 Inc. 16 Island Av #1-D . Miami-Beach, FL 33139 24 00000 DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT -ITEMIZED EXPENDITURES (1) Name Michael Gongora (2) I.D. Number 00000 (3) Cover Period 10 / 10 ~ 09 through 10 / 29 ~ 09 (4) Page 4 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 10 29 09 Washington Square Partners, Inc. Graphic Design MON $1,050.00 25 16 Island Av. #1-D Miami Beach, FL 33139 10 29 09 Post It 1480 NE 129 St. Mi i FL 33161 Mailers MON $609.74 26 am , 10 29 09 U.S.P.S. 1455 NW 107th Av. #106 Mi i F 33172 Postage MON $1,182.90 27 am , L 10 29 09 Print Farm 3511 NW 74th Av. i i Printing MON $807.85 28 M am , FL 33122 10 29 09 Print Farm 3511 NW 74th Av. Mia i FL 33122 Printing MON $517.45 29 m , DS-DE 14 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES J~ Q,~e l 9 /~ l9