Michael Gongora March 2011 t t .
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Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME — FIRST NAME — MIDDLE NAME. NAME OF AGENCY
GONGORA, MICHAEL CITY OF MIAMI BEACH
MAILING ADDRESS OFFICE OR POSITION HELD
1700 CONVENTION CENTER DRIVE COMMISSIONER
CITY ZIP COUNTY FeR QUARTER ENDING (CHECK ONE): YEAR
MIAMI BEACH, FL 33139 DADE c't RCH ❑JUNE OSEPTEMBER ❑ DECEMBER 20 I i
PART A — STATEMENT OF GIFTS
Please list below each gift, the value of which you believe to exceed $100, accepted by you during the calendar quarter for which this statement is
being filed You are required to describe the gift and stale the monetary value of the gift, the name and address of the person making the gift, and the
date(s) the gift was received If any of these facts, other than the gift description, are unknown or not applicable, you should so state on the form. As
explained more fully in the instructions on the reverse side of the form, you are not required to disclose gifts from relatives or certain other gifts. You
are not required to file this statement for any calendar quarter during which you did not receive a reportable gift.
DATE DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON
RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT
SEE ATTACH
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❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET ,c CA) 1 r1
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PART B — RECEIPT PROVIDED BY PERSON MAKING THE GIFT - :7 0
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If any receipt for a gift listed above was provided to you by the person making the gift, you are required to attach a cd79 of tICPreceipt to this
form. You may attach an explanation of any differences between the information disclosed on this form and the information on the receipt.
❑ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
PART C — OATH
I, the person whose name appears at the beginning of this form, do STATE OF FLO� I� A . to
COUNTY OF I .- Zy�.l rn
depose on oath or affirmation and say that the information disclosed Swom to1 or affirmed) and subs nbed before me this to
t_`. day of If1,I ,20 I' d_
herein and on any attachments made by me constitutes a true accurate, //��� _ o �,
by y — IT -— ' ,� O f'∎ - O
and total listing of all gifts re' ired to be reported by Section 112.3148, +- IMF
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=I rid-
tes. / ( g - nature of Note •ublic -Tate of Florida) o 2
(Print, Type, or Stamp Co issioned Name of Notary Public) u
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GNATURE OF REPO TING .FFICIAL N Personal) Known r m OR Produced Identification n'` .
Type of Identif Produced ��
PART D — FILING INSTRUCTIONS
This form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 32317 -5709; physi-
cal address: 3600 Maclay Blvd. South, Suite 201, Tallahassee, Florida 32312. The form must be filed no later than the last day of the calendar quarter
that follows the calendar quarter for which this form is filed (For example, if a gift is received in March, it should be disclosed by June 30.)
CE FORM 9 - EFF 1/2007 (See reverse side for instructions) 45I"
FORM 9 QUARTERLY GIFT DISCLOSURE
(ATTACHMENT)
RE: Commissioner Michael Gongora
Ticket Distribution for January — March 2011
City of Miami Beach Mayor and Commission Office
DATE EVENT VALUE
Jan 8 Miami City Ballet Program I
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $85.00 ea. $170.00
Feb. 3 -7 Miami Beach Antique show
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
8 tickets @ $15.00 ea. $120.00
Feb. 12 Miami City Ballet Program III
Provided by City bf Miami Beach
Miami Beach, FL 33139
2 ticket @ $.85.00 ea. $170.00
Feb. 25 -27 Miami Wine &Spirits Expo
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
4 tickets @ $75.00 ea. $300.00
Feb. 24 South Beach Food and Wine (Burger Bash)
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $200.00 ea. $400.00
Feb. 25 South Beach Food and Wine (Bubble Q)
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $ 350.00ea. $700.00
RE: Commissioner Michael Gongora
Ticket Distribution for January — March 2011 '
City of Miami Beach Mayor and Commission Office
DATE EVENT VALUE
Feb. 26 South Beach Food and Wine (Grand Tasting)
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $225.00 ea. $450.00
Mar.4 Miami Beach Fashion Week
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $250.00 ea. $500.00
Mar. 4 C.O.M.B. Wanda Sykes
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $66.50 ea. $133.00
Mar.5 C.O.M.B. Kevin Hart
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
4 tickets @ $55.50 ea. $222.00
Mar. 19 C.O.M.B. Gal Costa
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $73.00 ea. $ 146.00
Mar. 26 Miami City Ballet #5
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $89.00 ea. $178.00