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Rafael Granado Form 9 QTR IIMI A M I BEA CH 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 F o rm 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME -- FIRST NAM E -- MIDDLE NAME: NAME OF AGENCY: Granado, R af a el E. Citv of Miami Beach MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 Convention Center Drive City Clerk, City of Mi ami Beach CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR Miami Beach 33139 M-Dade J M AR C H 'JUN E 0SEPTEMBER O DECEMBER 2023 PA R T A - STAT E M E N T O F G IFT S P le ase list be lo w each gift , the valu e of w hich you believe to exceed $10 0 , accepted by you during the ca le nd a r quart er fo r w hich this statem e nt is being fil e d . You are req u ire d to de scrib e the gift and state the m o ne tary va lue of the gift, the na m e and ad d ress of the pe rson m a king the gift, and the da te(s) the gift w as received . If any of these fa cts, othe r tha n the gift de scrip tio n, are unknow n or no t ap plicab le , you sh ou ld so state on the fo rm . A s expla ine d m o re fully in the instructio ns on the re verse side of the fo rm , yo u are no t req uired to disclose gift s fro m relatives or cert ain other gifts. You are not required to fil e this statem ent fo r any calendar quart er during w hich you did not receive a reportable gift. D AT E D E S C R IP T IO N M O N E TA R Y N A M E O F P E R S O N A D D R E S S O F P E R S O N R E C E IV E D O F G IFT VA L U E M A K IN G T H E G IFT M A K IN G TH E G IFT A p ril 19, 20 2 3 I Ticket - eMerge U nkow n C ity of M iam i B each 1700 Convention D ID N O T A T T E N D C ntr D rive □CHECK HERE IF CONTINUED ON SEPARATE SHEET PA R T B RE CE I P T PR O V ID E D B Y PE R S O N M A K IN G T H E G IFT If any re ce ip t fo r a gift liste d ab o ve w a s pro vid e d to yo u by the pe rso n m a kin g the gift, you are re q u ired to att a ch a co p y of tha t receip t to this fo rm . Y ou m a y att ac h an exp la n a tio n of any diff e renc es be tw e e n the in fo rm a tio n disclo se d on this fo rm an d the in fo rm atio n on th e rece ip t. □CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM PA R T C - O AT H I, the pe rso n w ho se na m e app e a rs at the be gin n ing of this form , do de po se on oa th or aff irm a tio n and say tha t the info rm atio n discl o se d he rein an d on any att a chm e nts m a d e by m e constitutes a true accurate , and total listing of all gifts re qu ired to be re po rt ed by S e ction 112.3 14 8, sIGNniirE 3fl#EroRTING OFFICIAL s7Ar or r o pe ' pi .C[ couNr or kXjahz- e ?" to (or affirm ed ) an d sub s cribe d befor e m e by m e an s of hf vsj cal pre sen ce or [} on ine not ariza on . thi s _ 21 da y of Sep+ember ,zol-> EEt . Lura· es (P rint, Typ e , or Stamp Comj:'llk.kll.'liielk.llllfl:d 'llll'lit.ab P er s on al ly Kn own _ o} ride T ype of Id e ntificatio n P ro du ce PA R T D -- F IL IN G IN S T R U C T IO N S T his fo rm , w he n du ly sig n ed an d no ta riz ed , m ust be fil e d w ith the C o m m issio n on E thics, P.O . D raw er 15 7 09 , Talla ha sse e , Fl or id a 32 317 -57 0 9; ph ysi - cal ad d ress: 32 5 Jo h n K n ox R o a d , B u ilding E , S u ite 20 0 , Talla ha sse e , Flo rida 323 0 3 . The fo rm m ust be file d no la ter tha n the last day of the ca lend a r qua rt er th at fo llo w s the cale nd a r qua rte r fo r w hich this fo rm is file d (F o r exa m p le , if a gift is received in M a rch, it sh o u ld be discl osed by June 30 .) CE FORM 9 -EFF, 1/2016 (Ref er to Rule 34-7.010(1)(g), F.A.C.) (See reverse side for instructions) @ C ity C lerk 1700 C onvention C enter D rive M iam i Beach FL 33139 USPS CERTIFIED MAIL 111111 1111111 11 11 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