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Mark Taxis County Form (2) MIAMI BEACH OFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www.miamibeachfl.gov Telephone: 305.673-7411 March 31, 2020 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 2019, for the following City of Miami Beach Personnel: • Jimmy Morales— City of Miami Beach (City Manager) • Eric Carpenter— City of Miami Beach (Assistant City Manager) • Mark Taxis — City of Miami Beach (Assistant City Manager • Marcia Monserrat— City of Miami Beach (Chief of Staff) 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, 7‹, Rafael E. Granado, City Clerk Attachments REG:js Sent Certified Return Receipt RECEIVED MIAMI-DADE COUNTY MAR 31 2020 QUARTERLY GIFT DISCLOSURE CIN OFFIcF n OF MHAMITV BE CAE H LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: RK Taxis-Mark City of Miami Beach STREET ADDRESS: OFFICE OR POSITION HELD: 11271 Rockinghorse Road Assistant City Manager CITY:Cooper City FOR QUARTER ENDING(Check One): ZIP:33025 MARCH 0 NNE COUNTY:Broward o SEPT. DEC. YEAR:2010_ 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 December 2019 Art Basel Ticket $500 Art Basel December 2019 Design Miami Ticket $225 Design Miami C 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 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 FLORIDA this form, do depose on oath or affirmation and say COUNTY OF (Y1i a M i _ a that the information disclosed herein and on any attachments made by me constitutes a true, accurate, Sworn to(or affirmed)am}subscribed before me this and total listing of all gifts required to be reported by 3 / day of rn a f-Ch ,20 oQ a , Section 2-11.1 (e)(4) of the Code of Miami-Dade M Count by 1 ► 1 C' L Q.' i S (Name of Person Making Gift Disclosure) \ 714 uuw- �of Notary Public,State on. Signature f Person Making Gift isclosure (Print,Type,or Stamp Commissioned Name of Notary Public) 'ersonally known to me or 0 Produced Identification Type of Identification Produced: MARIA CHRISTINA BAGUER I COE 02/2010 . Notary Public-State of Florida i ®` Commission#GG 294734 or ry My Comm.Expires Jan 24,2023 Bonded through National Notary Assn. City of Miami Beach USPS CERTIFIED MAIL City Clerk 1700 Convention Center Dr Miami Beach FI 33139 11 9214 8901 9403 8310 2370 06 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:Jason Salvatore Code Violation#: Court Case#: Property Address:: Permit ID#: Custom 5: Postage:$5.9000