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Patrick Camm County Form Quarter I MIAMI BEA H OFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www.miamibeachfl.gov Telephone: 305.673-7411 June 4, 2019 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 March 2019, for the following City of Miami Beach Personnel: Patrick Camm — City of Miami Beach (Records Management Specialist) 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 MIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: Cjl,r^ I' i ^ l Ck 1�Q 'C AAVLYvi BOSCE OR POSITION HELD: C t y ��A I STREE ADDRESS: 1700 Conder},or C1-r OCIJt eco( 5llanac EMPn� 51VCACI t(S 1 CITY: M i 0.M3 ectc-h FOR QUARTER ENDING(Check One)! ZIP: J 13� MARCH 0 JUNE CI SEPT. 0 DEC. YEAR:2019 COUNTY: M l ar-►1 -Dai e, 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 ClX1'a-Co\42+ickels) arv,rni5516net '(7L1o(o,nvcnkonae Fed Z2�20tq 43ecchs: c, 664415S6 ka1qM \ Alerear, ()rive,A4ict . r3eaefn 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 on 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 1St 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 IDAQC this form, do depose on oath or affirmation and say COUNTY OF in t AptAt - that the information disclosed herein and on any to(or aff rmed and subscril1before me this Y attachments made by me constitutes a true, accurate, S rn da of i . —,20 I , and total listing of all gifts required to be reported by Section 2-11.1 (e)(4) of the Code of Miami-Dade by /�-TX ' C ry County. �C.me of Person Making Gift Disclosure) Al / ,4 _____________ (Signature of Notary Public,State of Florida) Si_ at re of Person Making Gift Disclosures_ �ksonl r'-C' (Print,Type,or Stamp Commissioned Name of Notary Public) lPersonally known to me or 0 Produced Identification Type of Identification Produced: .y TZ,,,, JASON SALVATORE ir+( aA. ' MY COMMISSION#GG 030527 ' lio,l �:: COE 02/2010 , .�. EXPIRES:September 14,2020 �'"tqr,;;:t: Bonded Thru Notary Public Underwriters U/,HLU H0 JVl7Cvvrr I VI 1111 IC I wnet VI UUG I c,ul.a-1,u.a.uvaui IJIUG Kusa p,CCCIllwu Uy I IIC IV0M/1101 r to IN Uval U I IWCLCU Uy vuy l out canoxu,c GET SOCIAL SC)B1VVFF #SOBEWFF EAT.DRINK.EDUCATE. ,. ., 7 T ` d,... yew • —_ t 00 t COOKING j . FEB 20-24 201 •:„ . , .,t, SOBEWFF,O ,, .... ,. , , , ,.., `. �pyyyrrr `'.--t-i. . ., , EAT. DRINK. EDUCATE., .:, .— , ,,,,,,,,,64. 4,At ..,_ I tt, s y.,c Q Search 'I i Create an Account SOBEWFF>SATURDAY EVENTS Coca-Cola Beachside BBQ presented by The National Pork Board hosted by Guy Fieri 1 Email/Account# Event Date:Saturday, February 22,2020 at 7:00 pm Password Promotions Where: Login Marriott Bonvoy North Venue Beachside at Delano-Entrance at 1 Lincoln Road New User Miami Beach,FL Forgot Password? When Saturday,February 23 7:00 PM-10:00 PM Fan-favorite rockstar chef,restaurateur, Emmy Award-winning television personality and New York Times'bestselling author Guy Fieri is'no stranger to hosting the Festival's most iconic barbecue celebrations,previously serving as host in 2012 and 2015.With all that experience under his belt,plus curating a featured barbecue area at Stagecoach this past year,he's back on the beach with his signature high-energy style to help us round up more than 30 of the nation's top grill maestros.They will churn out mouth-watering creations of beef,pork,poultry,and more cooked low and slow to serve up both classic and non-traditional barbecue flavors. These savory samplings will be accompanied by wines,spirits and captivating,live country-rock performances by GRAMMY award-nominated artist Cassadee Pope and Lukas Nelson&Promise of the Real to cap off this carnivorous celebration! Pope,the first female winner of NBC's The Voice,will croon the night away with her melodious hits like"Take You Home"and"One More Red Light,"as Nelson,co-producer of the music for the 2018 film A Star is Born and son of the legendary Willie Nelson,and POTR will light up the beach with their soulful hits like"Set Me Down on a Cloud"and"If I Started Over!" Review the Festival's strict bag policy at sobewff.org/bagpolicy How many tickets? Price Level: General Admission Limit of eight(8)tickets per event per transaction. Price Quantity Adult 0 $175.00 Add to Cart 0 masterca rd Food Network&Cooking Channel South Beach Wine&Food Festival prefers Mastercard® Mastercard Benefits: Mastercard Exclusive Event-Sunset Stone Crab hosted by Emeril Lagasse Mastercard Preview-Early Access! Chat Now e Barilla's Italian Bites on the Beach sponsored by HCP Media and the Miami Herald Media Compa 01111 https://ev1.evenue.net/cgi-bin/ncommerce3/SEGetEventlnfo?ticketCode=GS%3ASOBE%3ASOBE 19%3ABBQ%3A&linkl D=img-sobe&shopperContex... 1/2 City of Miami Beach USPS CERTIFIED MAIL City Clerk 1700 Convention Center Dr Miami Beach FI 33139 11 H1111 I I i 9214 8901 9403 8384 2347 27 MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS 111 NW 1ST ST UNIT 17-10 MIAMI FL 33128-1902 Fold Here Return Reference#: Username:Charles Dagostin Code Violation#: Court Case#: Property Address:: Permit ID#: Custom 5: Postage:$5.6000