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Diana Fontani County Form MIAMI BEACH OFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www.miamibeachfl.gov Telephone: 305.673-741 1 September 28, 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 Miami-Dade County Quarterly Gift Disclosure Form, for the quarter ending June 2018, for the following City of Miami Beach Personnel: Gloria Salom — Commission Aide (City of Miami Beach) Diana Fontani — Commission Aide — (City of Miami Beach) 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, Rafael E. Granado. City Clerk Attachments REG:cd Sent Certified Return Receipt 7017-1450-0002-2744-0297 MIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: Nkan fntxJ I e-7 C.1st of ern 1 Beci(-19 STREE ADDRESS: ) OFFICE ORP SITION HELD: 1`?b Conve ,) C .toelifert rise Alcie to Comrnisc`e4er & -' e orc CITY: 7iCo tiN Becks_ 1-. FOR QUARTER ENDING(Check One): - .J ZIP: Cl ❑ MARCH Q JUNOE COUNTY: 0.Ck f'_ ❑ SEPT. 0 DEC. YEAR:20 ( J 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 DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT ©`-}t b;1-)X31 tr SSS a©� r()‘(Ice/ {�a/k-04 cu i (� '1 jaolao'i S ({S 'LAny t ( a l) t ctrevi E L OS IIs( aal ( C-,a a- 1.�S�hlctrb ey 41_a-Ci 0 Geo(5e._ Peck,/ kavv,%) CHECK HERE IF CONTINUEDµON SEPARATE SHEET.L� 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 1"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 STATE OF FLO)),tIpA this form, do depose on oath or affirmation and say COUNTY OF t —DF3-0 Q that the information disclosed herein and on any attachments made by me constitutes a true, accurate, Sworn to(or affirmed)and subscribed before me this and total listing of all gifts required to be reported by Z.l day of S 'T ,20 IP Section 2-11.1 (e)(4) of the Code of Miami-Dade Count . by Di A N A Iva.-1 2. 1 mtz"r-) (Name of Person Makin Gift Disclosure) Si lure of Notary Pu lic,State of Florida) (Sig Y Sign. u e . P rson Making Gift Disclosure ({7_A 1?"sE� �: CAAAnt) �(P�nt,Type,or Stamp Commissioned Name of Notary Public) Iticrsonally known to me or 0 Produced Identification Type of Identification Produced: .•a�o�.,, RAFAEL E.GRANADO Notary Public-State of Florida COE 0212010 _• Commissionpi r GG l 6.722 My Comm.Exres Sep 16.2021 •.',F cc,+`,:'' eer•ded th.rugh Natoli Notary Asir. Nam__ 0& h + 14ai-1 ivmf. z. 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