Commissioner Gongora Form 9 QTR I+4 M/BEACH l V t l i V ii
O FFIC E O F TH E CI TY C LERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www._miamibegchf],goy
Telephone: 305.673-7411
June 30, 2021
Florida Com m ission on Ethics
P.O . D raw er 15709
Tallahassee, FL 32317-5709
Pursuant to S ec. 112.3148, Florida Statutes, please find a Q uarterly G ift Disclosure State Form
(9), fo r the quarter ending March 2021, fo r the following City of Miam i Beach Personnel:
• M ichael G óng ora - Com m issioner
• S teven J. Meiner- C om m issioner
• M icky Steinber g - C omm i s si on er
Should you have any questions or require any additional inform ation, please contact me at
305.673. 7 411.
71·
Rafael E. G ranado,
City C lerk
A ttachm ent
REG :cd
Sent C ertified Return Receipt
F o rm 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME -- FIRST NAME -- MIDDLE NAME NAME OF AGENCY
Góngora - M ichael City of Miami Beach
MAILING ADDRESS: OFFICE OR POSITION HELD
1700 Convention Center Drive Commissioner
CIT. ZIP COUNTY. FOR QUARTER ENDING (CHECK ONE): YEAR
M iam i Beach 33139 Dade M AR CH 0JUNE □SEPTEM BER □DECEM BER 2021
PA R T A - STATEM ENT OF GIFTS
Please list below each gift, the value of w hich you believe to exceed $100, accepted by you during the calendar quarter for which this statement is
being filed. You are required to describe the gift and state the m onetary value of the gift, the nam e and address of the person making the gift, and the
date(s) the gift w as received. If any of these fa cts, other than the gift description, are unknow n or not applicable, you should so state on the form. As
explained m ore fully in the instructions on the reverse side of the fo rm , you are not required to disclose gifts fro m relatives or certain other gifts. You
a re not requ ired to fil e this sta te m e nt fo r an y ca le nd a r qua rt e r du rin g w hic h you did not receive a report able gift .
DATE DESC R IPTIO N M ONETARY NAM E OF PERSON ADDRESS OF PERSON
REC EIV ED O F GIFT VALUE MAKING THE GIFT MAKING TH E GIFT
U1/212U al Two dinners at Santorini 200 Georg1os IOI Ocean Drive
during the anniversary M iami Beach, FL
where a pro clam aiton was
presented
($100 each )
□CHECK HERE IF CO NTINUED O N SEPARATE SHEET
PA RT B RE C EI PT PRO VIDED BY PERSON MA KING THE G IFT
If any receipt for a gift listed above was pro vided to you by the person m aking the gift, you are required to attach a copy of that receipt to this
form . You m ay attach an explanation of any differences betw een the inform ation disclosed on this fo rm and the inform ation on the receipt.
□CHECK HERE IF A RECEIPT IS ATT ACHED TO THIS FORM
PART C - OATH
I, the person w hose nam e appears at the beginning of this fo rm , do
depose on oath or affirm ation and say that the info rm ation disclosed
herein and on any attachm ents m ade by m e constitutes a true accura te,
and total listing of all gifts required to be reported by Section 112.3148,
STATE OF FLO RID~
cour or I llAtl - DA0E
Sworn to (or affi rm ed) and subscribed befo re me by means of 06egy%2en efp3ggrao. is 3O sayo IN aoZ/
Pp ß6g>
(Print , Type , or St amp Comrjs sion ed Name of Notary Public)
Person ally Kn own ie OR Produced Identi fication
Type of Identification Pro duced •
PA RT D FILING INSTRUCTIO NS
This form , w hen duly signed and notarized, m ust be filed with the Com m ission on Ethic ·
cal address: 325 John Knox Road, Building E, Suite 200, Tallahassee, Florida 32303. T
quarter that follow s the calendar quarter fo r which this fo rm is filed (For exam ple, if agi
CE FORM 9- EFF, 1/2016 (Refer to Rule 34-7.010(1)(g), F.A.C.)
Cci6il
Comm issio ágGr t4 72e side)for instructio
My Comm. Expires Sep 16, 2021
erded through Natierl htary Assn.
City Clerk
1700 Convention Center Drive
Miami Beach FL 33139
USPS CERTIFIED MAIL
I 11111 II
9214 8901 9403 8343 7239 41
FLORIDA COMMISSION ON ETHICS
PO BOX 15709
TALLAHASSEE FLORIDA 32317-5709
Fold Here
Return Reference Number:
Username: Patrick Camm
Code Violation # :
Court Case #:
Property Address ::
Permit ID#:
Custom 5:
Postage: $5.8600