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Dennis Leyva County FormMIAMIBEACH OFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www. miamibeachfl.aov Telephone: 305.673-741 1 March 12, 2017 Miami -Dade Clerk of the Board of County Commissioners 111 NW 1St Street, # 17-10 Miami, FL 33128 Pursuant to Section 2-11.1(e)(4) of the Code of Miami -Dade County, attached please find a copy of the Miami -Dade County Quarterly Gift Disclosure Form, for the quarter ending December 2017, for the following City of Miami Beach Personnel: • Brandi Reddick — City of Miami Beach (Cultural Affairs Program Manager) • Dennis Leyva — City of Miami Beach (Art in Public Places Administrator) • Eva Silverstein — City of Miami Beach (Director of Tourism, Culture & Economic Development • Luis Wong — City of Miami Beach (Senior Administrative Manager) • Linette Nodarse — City of Miami Beach (Special Events Production Liaison) The original has been filed with the Miami Beach Office of the City Clerk. Should you have any questions or require any additional information, please contact me at 305.673.7411. Respectfully, Ffael . Granado, City Clerk Attachments REG:cd Sent Certified Return Receipt 7017-1450-0002-2744-0150 MIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME -FIRST NAME -MIDDLE NAME: Leyva, Dennis STREE ADDRESS: 1700 Convention Center Drive CITY: Miami Beach ZIP: 33139 COUNTY: Miami -Dade NAME OF AGENCY: City of Miami Beach OFFICE OR POSITION HELD: Art in Public Places Administrator RECEi V D 2OI8 MAR -9 PM 4:20 FOR QUARTER ENDING (Check One): MARCH ❑ SEPT. DEC. ❑ JUNE YEAR: 2011 ,:EACH Y PART A: STATEMENT OF GIFTS. List below each gift, or series of gifts, from one person or entity in excess of $100, accepted by you during the calendar quarter for which this statement is being filed. Describe the gift and state the monetary value of the gift, the name and address of the person making the gift, and the dates the gifts were received. If any of these facts are unknown or not applicable, state this on the form. You are not required to file this statement for any calendar quarter during which you did not receive a reportable gift. DATE RECEIVED 12/5/2017 12/5/2017 DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON OF GIFT VALUE MAKING THE GIFT Art Basel VIP card $150.00 Bob Goodman Design Miami VIP card $150.00 Jen Roberts MAKING THE GIFT 300 41St Street, Ste 214 Miami Beach, FL 33140 3841 NE 2nd Ave, Ste 400 Miami, Florida 33137 CHECK HERE IF CONTINUED ON SEPARATE SHEET. ❑ 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. CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM. ❑ PART C: FILING INSTRUCTIONS. The signed and notarized form must be filed no later than the last day of the calendar quarter that follows the quarter for which this form applies. For example, if a gift is received in March, it should be disclosed by the end of the next quarter, i.e., June 30. County personnel file with the Clerk of the Board of County Commissioners, 111 NW lst St., Suite 17-10, Miami, FL 33128. Municipal personnel file with their respective municipal clerks. PART D: OATH. I, the person whose name appears at the beginning of this form, do depose on oath or affirmation and say that the information disclosed herein and on any attachments made by me constitutes a true, accurate, and total listing of all gifts required to be reported by Section 2-11.1 (e)(4) of the Code of Miami -Dade County. Signa ure of Person aking Gift Disclosure COE 02/2010 GERALDINE TOUSSAINT �v. P�ot•,. Notary Public - State of Florida ," Commission # GG 060275 4 ��,� .>?;c My Comm. Expires Jan 5. 2021 Of fL` Bonded through National Notary Assn. r STATE OF FLORIDA COUNTY OF MI Gu'ri — DAM__ Sworn to (or affirmed) and subscribed before me this 21,o day of �ctnuwv` , 20 l� by befI1t (Name of Person Making Gift Disclosure) (Signature of Notary Public, State of Florida) (Print, Type, or Stamp Commissioned Name of Notary Public) i 'Personally known to me or 0 Produced Identification Type of Identification Produced: CO e N ® <AD _ N� 0.) -. 1 Tl N r 0 rD v — w COco sommi v N 0 W Co saauo!ss!wwoj Alunoj jo paeog aye jo laao aped-iweiw B. Received by (Printed Name) 2 0 r fD 0 ❑ 0 > > 0 a m N (0 `< (D n •1103S SIH1 3137d1N00 :U3. k 0 NO NOI103S SIHI 31.37d141* . (T M Ce L' 0 w -0 U r U F w 2 � • E 0 _o w 0 0 V c C Y L Ca C 0 E O c_ > i 0 0 o 0 u�- O p U1 Lrt 1-9 rR 0 p U.S. Postal Service"'' CERTIFIED MAIL° RECEIPT Domestic Mail Only • .•1 • 1 . . 1 1.__ I 1 L . - Certified Mat Fee r- r- $ n.J f Extra Services & Fees (check box, add fee as appropriate) 0 Retum Receipt (hardcopy) $ 0 • O ❑ Retum Receipt (electronic) $ ❑ Certified Mail Restricted Delivery $ 0 Adult Signature Required $ p p 0 Adult Signature Restricted Delivery $ p Postage u7 u'7 $ Total Past rR a r- C`- Sent To r-9 ra 0 0 Street and r- r- Ciry, State, JSE Postmark Here Miami -Dade Clerk of the Board of County Commissioners 111 NW 1st Street, # 17-10 Miami, FL.33128 II) tot