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Gongora, Michael Submitted August 21, 2023MIAMI BEACH CITY OF MIAMI BEACH REPORTING OF SOLICITATION OF CONTRIBUTIONS FOR POLITICAL COMMITTEES AND ELECTIONEERING COMMUNICATIONS ORGANIZATIONS In accordance with City of Miami Beach Ordinance 2023-4557, codified in Sections 2-487 through and including 2-490 of the Miami Beach City Code, a candidate for the offices of Mayor or Commissioner or a member of the City Commission must file, prior to engaging in solicitation activities (not otherwise prohibited by the aforementioned City Code sections), this Form to publicly disclose their solicitation fundraising activities for Political Committees or Electioneering Communications Organizations. Upon completion, this Form must be filed with the City Clerk (see filing instructions below), to be filed on a one-time basis disclosing solicitation for a particular Political Committee or Electioneering Communications Organization. e Elected Official's or Candidate's Na Address (number and street) City, State, Zip Code OFFICE USE ONLY; -, a ii-, + -- en 13 ±.. -7 --r E- oz± -O 1: ---1t3 --+] ;> -) rnz -> Prior to commencing solicitation activities (not otherwise prohibited by Article VII, Division 5, Sections 2-487 through and including 2-490 of the Miami Beach City Code), either directly or indirectly, on behalf of a Political Committee which supports or opposes candidates for City elected office, or Electioneering Communications Organization which makes expenditures for electioneering communications relating to candidates for City elected office or accepts contributions for the purpose of making such electioneering communications, a candidate for the offices of Mayor or Commissioner, or a member of the City Commission shall file this one- time Report with the City Clerk indicating that the candidate or member of the City Commission is undertaking solicitation activities on behalf of such Political Committee or Electioneering Communications Organization. noo a. El. 6a a ae tort e offices of Miami Beach Mayor or Commissioner Office: tt...d... .h ls.i D Member of the Miami Beach City Commission Office: ----------------------------------- I will be commencing solicitation activities on behalf or []. D Political Committee ~lectioneering Communications Organization • Full Name of the Political Committee or Electioneering Communications Organization: leaces le 1us± • • Address of the Political Committee or Electioneering Communications Organization: 2coo 5.laDgl Rd.,te @), G IG,f _3zr4 T T T T • Telephone number of the Political Committee or Electioneering Communications Organization: &)'44¢ 0717 • Name of the Registered Agent for the Political Committee or Electioneering Communications Organization: Joe A._ ece • Name of the Chairperson or Treasurer for the Political Committee or Electioneering Communications "" t eo • Name of the jurisdiction where the Political Committee or Electioneering Communications Organization filed its statement of organization (e.g., either the City of Miami Beach, Miami-Dade County, or the State of Florida): tale se Flo«la • Describe the relationship between the Candidate or member of the City Commission (as applicable) and the Political Committee or Electioneering Communications Organization: Capes>n C E R T IF IC A T IO N It is a first-degree misdemeanor for any person to falsify a public record (sec. 839.13, Fla. Stat.) hereby acknowledge that it is my responsibility to read, understand, and follow the campaign finance requirements described in this Article VI I, Division 5 of the Miami Beach City Code. I certify that I have examined this report and it is true, correct, and complete. .Ibey}... son~iore ; Ml el es;ea Type or Print Name [z]23 Date [] Elected octal [EU6~didate Form# MBCC 1 Created On May 17, 2023 I Ordinance 2023-4557 Once the form is completed, print it, sign it, and submit an electronic copy to the Office of the City Clerk at CityClerk@miamibeachfl.gov. You may also mail or hand deliver the form to the Office of the City Clerk, Miami Beach City Hall, 1700 Convention Center Drive, Miami Beach, FL 33139. For more information, please contact the Office of the City Clerk at 305.673. 7 411 or via email at CityClerk@miamibeachfl_gov. F:\CLER\CLERI000_ELECTION\aaFORMS\MBCC 1 - REPORTING OF SOLICITATION OF CONTRIBUTIONS FOR PC & ECO.docx