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Heather Shaw County Form QTR IIMIAMI BEACH OFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www.miamibeachll.gov Telephone: 305.673-7411 September 12, 2023 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 June 2023, for the following City of Miami Beach Personnel: Rickelle Williams - City of Miami Beach Economic Development Director Heather Shaw - City of Miami Beach Economic Development Assistant Director 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. Rafael E. Granado, City Clerk Attachments REG:cd Sent Certified Return Receipt M IAM I-DADE CO UNT Y Q UARTERL Y G IFT DISCL O SU RE LAST NAME-FIR ST NAME-MID DLE NAME: NAME OF AGENCY: Shaw, Heather City of Miami Beach - Economic Development STREE ADDRESS: OFFICE OR POSITION HELD: 1700 Convention Center Dr. Assistant Director CITY: Miami Beach FOR QUARTER ENDI NG (Check One): ZIP: 33139 0 MARCH JUNE COUNTY: Miami-Dade 0 SEPT. D DEC. YEAR: 2023 PART A: STATEMENT OF GIFTS. List below each gift, or series of gifts, from one person or entity in excess of$ I 00, 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 6.12.23 /IUU LIScayne 1Ivd. Deco Pass for ABFF $650 Yvette Harris Ste. 210 Miami, FL 3313 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 form and the information on the receipt. CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM. 0 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 I st 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. STATE OF FLORID A COUN TY OF pMimi po de Sworn to (or affirmed) and subscribed before me this 30 day of9s ,2023 by. leoalher Shu» (Name of Person Making Gift Disclosure) a.Mil. 7 Noury Po@ice. Seate or Fiori@@» Stephanie eA Broog / Print, Type, or Stamp Commissioned Name of Notary Public) 6 Personally known to me or [ Produced ldentification Type of Identification Produced. COE 02/2010 ;°lm··~v ~11~, STEPHANIE NICOLE REY BROOKS ifs ? Notary Public - State of Florida 3'' if} commission ir H 347040 ,95.f%°° My Comm. Expires Jan 8, 2027 Bonded through National Notary Assn. City Clerk USPS CERTIFIED MAIL Ill I 1111 II Ill 9214 8901 9403 8329 7832 59 MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS 111NW 1ST ST UNIT 17-10 MIAMI FL 33128-1902 Fold Here Return Reference Number: Username: Charles Dagostin Code Violation # : Court Case #: Property Address : : Permit ID#: Custom 5: Postage: $7 .1800