Mayor Gelber Form 9 QTR IIM IA M I 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
September 29, 2023
Florida Commission on Ethics
P.O. Drawer 15709
Tallahassee, FL 32317-5709
Pursuant to Sec. 112.3148, Florida Statutes, please find Quarterly Gift Disclosure State Form
(9), for the quarter ending June 2023, for the following City of Miami Beach Personnel:
• Dan Gelber - Mayor
• Alex J. Fernandez- Commissioner
• David Richardson - Commissioner
• Rafael E. Granado - 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:rq
Sent Certified Return Receipt
City Clerk
1700 Convention Center Drive
M iam i Beach FL 33139
USPS CERTIFIED MAIL
11 111 I
9214 8901 9403 8332 1135 24
FLORIDA COMMISSION ON ETHICS
PO BOX 15709
TALLAHASSEE FLORIDA 32317-5709
eturn Reference Number:
sername: Patrick Camm
ode Violation # :
ourt Case#:
roperty Address : :
ermit ID#:
ustom 5:
ostage: $8.8600
Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
L$T NA! FIRST NA
7. e
MAILING ADDRESS7 · O'
ENDING (CHECK ONE):
JUNE □SEPTEMBER O DECEMBER
YEAR
20 3
PART A- STATEMENT OF GIFTS
Please list below each gift, the value of which 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 monetary value of the gift, the name and address of the person making the gift, and the
date(s) the gift was received. If any of these facts, other than the gift description, are unknown or not applicable, you should so state on the form. As
explained more fully in the instructions on the reverse side of the form, you are not required to disclose gifts from relatives or certain other gifts. 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
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ocirca
'U CHECK HERE IF CO NTINUED 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.
0 CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
PARTC-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 112.3148,
Florida Sta::::=? t:f
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SIGNATURE OF REPORTING OFFICIAL
STATE OF FLORIDA
COUNTY OF Memi- Dsee
Sworn to (or affirmed) and subscribed before me by means of
))onyst~al presence or L}onine notarization, this 3
A dayor 5<gheme2o_--
Dan elbes
(Signature of Notary Public- '·, ",
° % ·· .. \
(Print, Type, or Stamp Commissioned N
Personally Known ZS OR Produ
Type of Identification Produced ' solve tr
PART D - FILING INSTRUCTIONS
o,, f4 '·..·
This form, when duly signed and notarized, must be fled with the Commission on Ethics, PO. Drawer 15709, Tallahass #{S +s physi-
cal address: 325 John Knox Road, Building E, Suite 200, Tallahassee, Florida 32303. The form must be filed no later than the last day of the calendar
quarter that follows the calendar quarter for which this form is filed (For example, if a gift is received in March, it should be disclosed by June 30.)
C E FO RM 9 - EFF, 1/20 16 (Re fer to R ul e 34-7.0 10 (1)(g ), FA.C.) (See reverse side fo r instruct ions) r:tr
DATE GIFT ESTIM ATED VA LU E DO N O R/G O V ERN M ENT
4/7/2023 SAVE Foundation Fundraising Event $100 Jane Toll
4/14/2023 The Fresh and Fierce feat. West Side Story Suite (2 tickets, $195pp) $390 Miami City Ballet
5/23/2023 Yeti Mug $30 Anita Ward/ Care Solace
6/30-7-2/2023 Florida SuperCon 2023 Show (2 Tickets) $110 Florida SuperCon 2023 Show