Christopher Marin QTR I County FormMIAM I BEACH
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www .miamibeachtl,_go
Telephone: 305 .673 .7 411
Jan uary 5, 2021
Miami-Dade Clerk of the
Board of County Commissioners
111NW 1°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 2021, for
the following City of Miami Beach Personnel:
• Corey Jackson - Miami Beach Police Officer
• Traci Sierra - Miami Beach Police Officer
• Christopher Marin - Miam i Beach Police Officer
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. 7 411.
Rafael E. Granado,
City Clerk
Sent Certified Return Receipt
City Clerk
1700 Convention Center Drive
Miami Beach FL 33139 I I
USPS CERTIFIED MAIL
11 111 I
9214 8901 9403 8329 0621 01
MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS
111NW 1ST ST UNIT 17-10
MIAMI FL 33128-1902
Fold Here
Return Reference#:
Username: Patrick Camm
Code Violation # :
Court Case #:
Property Address : :
Permit ID#:
Custom 5:
Postage: $6.0500
JAN 0 4 2021 @)
MIAMI-DADE COUNTY
QUARTERLY GIFT DISCLOSURE
LAST NAME-FIRST NAME-MIDDLE NAME:
Ms,s lo gk¢
STRE E ADDRESS:
Ho6 ) P,..vc,
CITY: M +••
z1P: ,313
COUNT. fez. l
M\u4: Ac
0) er
FOR QUARTER ENDING (Check One):
(2N-MARCH
□SEPT. □DEC.
□JUNE
YEAR: 202,
.-es, sr -"<;;'.~:;;,,' ífj% 72, ¿o ;
3.==..è$ %5$"< t,,,,,,,';! '?: ---
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
€cw'3 /\. 400 es LA4, A, » fe2 0""t le-y
6\lez1 ro»z fel (J as. 3@? 2w pM
• a et, a' .
I I #M' guro.
o l•
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 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
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.
S·~1D·1 ignature of Person ing ii hisclosure
COE02/2010
RECEIVED
JAN 4 202l
CITY OF MIAM I BEACH
OFFICE OF THE COTY CLERK
STATE OF FLORIDA
COUNTY OF Ini - DO <
Sworn to (or affirmed) and subscribed before me this
day op er<. 202 \
by_ 4_roec se»
(NVare of Pere alano t7mielo
(A - (Ns?
(Prin t, Type. or Stamp Commissioned Name of Notary Public)
□Personally known to me o~ced Identification
Type of Identification Produced: _
±° : "AU" > &. 3 $.Ee.°
RAFAEL E. GRANADO
Notary Public - State of Florid2
Commission # GG 106172
My Comm. Expires Sep 16, 2021
Bar ded through Natiaral Nctery Assn.
Acosta, Paul
Fro m :
S e n t:
T o :
S u bje ct :
Williams, Latoya <Lwilliams@OrangeBowl.org >
Thursday, December 31, 2020 4:46 PM
Acosta, Paul
FW: Capital One Orange Bowl
Im p o rt a n ce : High
[ THIS MESSAGE COMES FROM AN EXTERNAL EMAIL - USE CAUTION WHEN REPLYING AND OPENING LINKS OR
ATTACHMENTS]
Hello Assistant Chief Acosta,
We actually have two (2) boxes we can offer you to distribute for a total of eight (8) tickets, four (4) per Luxury Box.
Therefore you have the opportunity to provide two (2) officers the ability to have 3 guest each or four (4) officers the
ability to have 1 guest each. See the options broken out below.
"" Box#1 é.,, G u e st Op ti on s To tal # Ti cke ts
1 Officer 3 Guests 4
O r
2 Officers 1 Guest/Officer (will be 4
in the same box}
. - . B ox #2 G u e st O ptio ns Tota l# Tickets -
1 Officer 3 Guests 4
O r
2 Officers 1 Guest/Officer (will be 4
in the same box}
Please give me a call if you have any questions or need more information. Remember for each officer I will need to
receive their contact information to include their Full Name, prefer telephone number and email address in or to send
their tickets with instructions.
Thank you,
1
r:zar.IL.
LAT O Y A W ILL I A MS • VP , Co m m u ni ty Ou tr ea ch • O : 3 0 5 -34 1 -4 7 2 8
CapitalOne
RN1GE BO UI f:= La.a
\,,,,. 2_g- _3,=
MIAMI 2 ·2 I
HO ST COM M ITTEE
ORANGE BOWL COMMITTEE • 14360 NW 77th Court .· Miami Lakes, FL 33016
1.2.21ta r eE 1.11.21Ex --sr
00@00
From: Williams, Latoya
Sent: Thursday, December 31, 2020 2:56 PM
To: 'paulacosta@miamibeachfl.gov' <paulacosta@miamibeachfl.gov>
Subject: Capital One Orange Bowl
Importance: High
Good afternoon Assistant Chief Acosta,
It was a pleasure speaking with you.
The Orange Bowl has a few of its premium boxes it would like to provide to those who have continually supported the
organization. We would like to provide one living room box for the Miami Beach Police Department to provide to an
officer(s) who have gone above and behind the call of duty while on the front lines during the pandemic.
The 72 Club Living Room Box is a four-person box and its tickets include all-inclusive food and beverage, premium Black
Card parking, TV's with closed-circuit telecast of the game, and plush seating located on the 35-40 yard lines. You may
offer the box to one(1) officer with three guests or two (2) officers with a guest each who do not mind being in close
proximity to each other. Once you have determined who you would like to provide this opportunity to, I would need to
receive their contact information to include their Full Name, prefer telephone number and email address.
The 2021 Capital One Orange Bowl will take place, Saturday, Jan 2, 8pm at Hard Rock Stadium and will feature the
Texas A&M Aggies and North Carolina Tar Heels. Tickets and additional game day information will be shared digitally,
therefore it is imperative the recipient(s) of the box provide an accurate email address.
We are very excited to share this opportunity with our first responders and appreciate all that you do for our
community.
If you have any questions or need more information, please feel free to contact me via email or on my cell at (305) 542-
8450.
Thank you,
2