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Michael Gongora - December 2010 Form 9 I I ' i 1 1 • 1 Farm °.9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER -x100) • LAST NAME—FIRST NAME—MIDDLE NAME: NAME OF AGENCY: • I .GONGORA, MICHAEL CITY OF MIAMI BEACH ! MAILING ADDRESS: OFFICE OR POSITION FIELD: i 1700 CONTENTION CENTER DRIVE COMMISSIONER CITY: ZIP: COUNTY: FOR QUARTER ENDING(CHECK ONE)' YEAR MIAMI BEACH, FL 33139 DADE D DMARCH OJUNE DSEPTEMBER `XDECEMBER 2040 1 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 1 being filed.You are required to describe the gift and state the monetary value of the gift,the name add 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.unknoivn 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 I MONETARY NAME OF PERSON ADDRESS OF PERSON RECEIVED OF GIB VALUE MAKING THE GIFT MAKING THE GIFT I i .SEE ATTACHED I , I i 1 • ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET I ! PART B—RECEIPT PROVIDED BY PERSON MAKING THE GIFT If any receipt for a gift listed above was provided to you by the person making the gift,you are required to attach a copy of that receipt to this form.You may attach an explanation of any differences between the information disclosed on this form and the information on the receipt. i O CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM I PARTC—OATH = . '='" TV . I,the person whose name appears at the beginning of this form,do STATE OF FLORIDA '7 'a,. COUNTY OF rilcav�i --Dock_ .'aa'15� I depose on oath or affirmation and say that the information disclosed Sworn to.(or affirmed)and subscribed before.me this 0 0. % .2(,,,P-1 day of :canUQv--D ,20 t1... r ;3 �; f herein and on any attachments made by me constitutes a true accurate, .J �..0 ,- by Is ., _ 0 :lb 40 • . _1. fo and total listing of all gifts re fired to be reported by Section 112.3148, ==f' ' j Florida St tes. (Signature of Notary(' .liu5',tate of Florida) ;T i d (Print,Type,or Stamp Co missioned Name of Notary Public) .';_, hs�` et arao,et, _, GNATUPE OF REPORTING OFFICIAL , Personally Known /' OR Produced Identification `:r`�' aar.�... i Type of Identification Produced r:;s� ,,+ITS` � ` ‘?"4;'. '''lima,` fie PART D—HUNG INSTRUCTIONS -•_tt: 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)�° f 1 FORIVI 9 QUARTERLY GIFT DISCLOSURE • (ATTACHMENT) RE: Commissioner Michael Gongora Ticket Distribution for October—December 2010 City of Miami Beach Mayor and Commission Office DATE .EVENT VALUE Oct 2 Myrim Hernandez Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets.@ $83.25 ea. $166.50 Oct 15-16 91'' Annual Garnd Tasting Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 4 tickets @ $75.00 ea. $300.00 Oct 16 Tosh Tour Twenty Ten Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 4 tickets @ $61.45 ea. $245.80 Oct 16 Miami City Ballet Program I Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets cr $85.00 ea: $170.00 Oct 23 Taste of Peru • Provided by'City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL.33139 2 tickets a $75.00 ea. $150.00 Oct 29 DJavan Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $68.00 ea. $136.00 RE: Commissioner Michael Gongora Ticket Distribution for October-December 2010 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE Nov 6 Lisa Lampanell.i Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets -cr $58.35 ea. $116.70 • Nov 27 Gilberto Santa Rosa Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $88.25 ea. $176.50 Dec 4 Willy Chirino Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @$88.25 ea. $176.50 Dec 18 The Nutcracker (Kirova Ballet) Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach,.FL 33139 4 tickets @ $89.75 ea. $359.00 Dec 18 The Nutcracker(Miami City Ballet) . Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 • 2 tickets @ $65.00 ea. $130.00 Dec 19 The Nutcracker (Kirova Ballet) Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $89.75.ea. $179-.00 Dec 31 Orange Bowl.Committee (Jam on the Sand) Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 -2 tickets @ $65.00 ea. • . .$130.00 • RE: Corririlissioner Michael Gongora Ticket Distribution for October- December 2010 . City of Miami Beach Mayor and Commission Office DATE EVENT VALUE Dec. 31 New Years Eve Party Provided by the Fontainebleau Hotel 4441 Collins Avenue Miami Beach, 2 tickets @ $250.00 each $500.00 • • • • • • • • •