Monica Salinas County Form QTR IIMIAMI 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
S e p te m b e r 2 9 , 2 0 2 3
M ia m i-D a d e C le rk of th e
B o a rd o f C o u n ty C o m m iss io n e rs
11 1 N W 1°St re e t, # 17 -10
M ia m i, F L 33 12 8
P u rsu a n t to S e ctio n 2-11 .1 ( e )( 4 ) of the C o d e of M ia m i-D a d e C o u n ty , att a c h e d ple a se fi n d a co p y
of th e M ia m i-D a d e C o u n ty Q u a rt e rly G ift Di sc lo s u re F o rm , fo r th e qu a rt e r e n d in g Ju n e 20 2 3 , fo r
th e fo llo w in g C ity of M ia m i B e a c h P e rso n n e l:
• A le x a n d ra D a n ie lle M e jia - D e p u ty C h ie f of S ta ff
• Mi ch el e P am el a B u rg er - Chief of St aff
• Li ssette Garcia Arrogante - Director of Tourism and Culture
• Monica Matteo-Salinas - Commission Aide
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.
#a
R afa e l E. Granado
City Clerk
Attachments
REG:rq
S e n t Certified Return Receipt
City Clerk
1700 Convention Center Drive
M iam i Beach FL 33139
USPS CERTIFIED MAIL
1111 I 1111111 11
9214 8901 9403 8332 1136 92
MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS
111 NW 1ST ST UNIT 17-10
MIAMI FLORIDA 33128-1902
eturn Reference Number:
sername: Patrick Camm
ode Violation # :
ourt Case #:
roperty Address ::
ermit ID#:
ustom 5:
ostage: $8.8600
M I A M I -D A D E C O U N T Y
Q U A R T E R L Y G I F T D I S C L O S U R E
LAST NAME-FIRST NAME-MIDDLE NAME:
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STREE ADDRESS:
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CITY: I'u €ac
zI P: 3 %24
COUNTY:
AME OF AGENCY:
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OFFICE O POSITION HELD:
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FOR QUARTER ENDING (Check One):
□MARCH
J SEPT. J DEC.
AP 1JNEg
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PART A: STATEMENT OF GIFTS. Li st bel ow each gift, or series of gifts, from on e pers on or entity in
excess of$ I 00, accepted by you dur ing the calendar quarter fo r w hich this statem ent is being filed. D escribe the gift
and state the m onetary value of the gift, the nam e and address of the person m aking the gift, and the dates the gifts
w ere received. If any of these fa cts are unknow n or not applicable, state this on the fo rm . 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
1l -2 -23 t let $1,«6 k M- 6
4-2 32 3 f hlet #s5o Code veah @«div«it.
6-1-23 &16 Mwit Cc.
as foal
CHECK HERE IF CONTI NUED ON SEPARATE SHEET. 0
PART B: RECEIPT PROVIDED BY PERSON MAKING THE GIFT. If any receipt fo r a gift
listed above w as pro vided to you by the person m aking the gift, you are required to attach a copy of that receipt to this
fo rm . Y ou m ay att ach an explanation of any differences betw een the info rm ation discl osed on this fo rm and the
info rm ation on the receipt. CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM. 0
PART C: FILING INSTRUCTIONS. T he signed and notarized fo rm m ust be filed no later than the last day
of the calendar quarter that fo llow s the quarter fo r w hich this fo rm applies. For exam ple, if a gift is received in M arch,
it should be disclosed by the end of the next quarter, i.e., June 30. C ounty personnel fil e w ith the Clerk of the B oard
of C oun ty C om m issioner s, IHI N W I St., Suite 17-10, M iami , FL 33128. M unic ip al personnel file wi th th eir
respecti ve m unicipal cl erks.
PART D: OATH.
I, the person w hose nam e appears at the beginning of
this fo rm , do depose on oath or affi rm ation and say
that the info rm atio n discl osed herein and on any
attachm ents m ade by m e constitutes a tru e, accura te,
and total listi ng of all gifts required to be reported by
Section 2-11.1 (e)(4 ) of the C ode of M iami -D ade
Co"nty. ,hJ
Signature of P erson M aki ng G ift D iscl osure
srr or r0j/)),
c o U N T Y OF ')a od e a
Sw orn to (or affi rm e ) and subscribe:l efo re m e this
Z_day of ow ,20 2
_ /(Prinl, Typ , or Stamp Commissioned Name of Notary Public)
lfersonally known to m e or [l Produced Identification
T ype of Identification Produced:
C O E 02/201 0
PATRICK D. CAMM
MY COMMISSION # HH 254869
EXPIRES: April 19, 2026