Cilia Ruiz Paz County FormA EACH
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.rniamibeachfl.cov
Telephone: 305.673.7411
March 26, 2018
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 Miarni-Dade County Quarterly Gift Disclosure Form, for the quarter ending December
2017, for the following City of Miami Beach Personnel:
• John Elizabeth Aleman — Commissioner — Group VI
• Cilia Maria Ruiz -Paz — Commission Aide
• Gloria Salom — Commission Aide
• Mark George Samulian Commissioner Group 11
The originals have 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,
Rafael E. Granado,
City Clerk
Attachments
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MIAMI-DADE COUNTY
QUARTERLY GIFT DISCLOSURE
LAST NAME -FIRST NAME -MIDDLE NAME:
RUIZ-PAZ, CILIA -MARIA
STREE ADDRESS:
1700 CONVENTION CENTER DRIVE
CITY:
ZIP: MIAMI BEACH, 33139, MIAMI-DADE
COUNTY:
NAME OF AGENCY:
CITY OF MIAMI BEACH
OFFICE OR POSITION HELD:
COMMISSION AIDE
FOR QUARTER ENDING (Check One):
0 MARCH
Ci SEPT. DEC.
18 MAR 26 PM if 17
t OF j4jRE
ICE Ur THE Cyri
eti
LE
0 JUNE
YEAR: 20 1
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
DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON
OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT
Event Ticket: Adaptive Beach 6475 Collins Ave
11/1/2017 Celebration (2 tickets) $500 Sabrina Cohen Miami Beach, FL 33140
CHECK HERE IF CONTINUED ON SEPARATE SHEET. 0
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. 0
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 Pt St., Suite 17-10, Miami, FL 33128. Municipal personnel file with their
respective municipal clerks.
PART D: OATH.
1, 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.
COE 02/2010
Ge) Disclosure
STATE OF FLORIDA
COUNTY OF .MI/- bne,-
Storn to (or affirmed) and subscribed before me this
24 day of N4-CA4 20 /
by ( A- /WA& /2,01Z.
• ,e of P • on Making Gift Disclosure)
(Signature of Notary Public, State of Florida)
1,A) tifrnz.lett;
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally known to me or 0 Produced Identification
'Type of Identification Produced:
JASON SALVATORE
MY COMMISSION11 GG 030527
EXPIRES: September 14,2020
Bonded Thru Notary Public Underwriters