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Kristen Rosen Gonzalez Form 9 QTR IOFFICE OF THE CITY CLERK City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139 www.miamibegchfl,gov Telephone 305.673-7411 June 26, 2023 Florida Commission on Ethics P.O. Drawer 15709 Tallahassee, FL 32317-5709 Pursuant to Sec. 112.3148, Florida Statutes, please find a Quarterly Gift Disclosure State Form (9) for the quarter ending March 2023, for the following City of Miami Beach Personnel: • Kristen Rosen Gonzalez - Commissioner (City of Miami Beach) Should you have any questions or require any additional information, please contact me at 305.673.7411. Respectfully, Ra~Granado, City Clerk Attachment REG:cd Sent Certified Return Receipt Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LA ST NAM E -- FIRS T NAM E -- MI DDL E NAME: NAME OF AGENCY: Rosen Gonzalez Kristen Citv of Miami Beach MAILING ADDRESS: OFFICE OR POSITI ON HELD: 1700 Convention Center Dr. Commissioner CITY. ZIP: COUNTY : FOR QUARTER ENDING (CHECK ONE): YEAR Miami Beach 33139 Miami-Dade MARCH □JUNE □SEPTEMBER O DECEMBER 2023 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 fonm , 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 01/26/23 2 Tickets to the annual $5000 The Bass Museum 2100 Collins Ave. Miami Bass Ball Gala of Art Beach, FL 33139 03/28/23 2 Tickets to perfromance $270 Adrienne Arsht Center 1300 Biscayne Blvd. My Fair Lady for the Performin g Art s Miami. FL 33130 03/04/23 2 Tickets to the annual $500 The Little Lighthouse 100 Biscayne Blvd. Little Lighthouse Gala Foundation Suite 1607 Miami FL 33132 03/06/23 2 Tickets to Aspen $1,000 Aspen Institute 2300 N Street, NW Suite 700 Conference Washington, DC 20037 D CHE CK HERE IF CONTINUED 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 fo rm . Yo u m a y att ac h an exp la na tio n of an y diff e re n ces be tw e e n the info rm a tio n disclo se d o n th is fo rm an d th e information on the receipt. ~f CHE C K HE RE IF A RE CEI PT IS ATTACHED TO TH IS FO RM PART C OATH I, th e pe rso n w ho se na m e a p p e a rs at the beg in n in g of this fo rm , do de p o se on oath or affi rm a tio n a nd sa y tha t the info rm atio n discl o se d he re in and on any.,a tta chm e nts m ad e by m e co nstitutes a true accu ra te , an d total lisv\g 1'-4 '"~u ired to be rep o rt ed by S ectio n 112 .3 14 8 , Flo rid a S tatute{ y \ l swr eor 0 %/aa- £+0y c o u N T Y OF /UL rT ee t 'ld ?W9r to (or affi rm e d ) an d su b scribe d before m e by m e an s of p9teem=saeyr . 23 'z o1 da y of )Lu e 2 o_d k " - (P rin t, Type , or S ta m p C P e rso na lly K no w n Type of Id e ntifi catio n P ro TIN 165705 ,"PE}#is?pocember 14, 2025 Bonded -Thru Notary Public Undeniters PART D - FILI NG INSTRUCTIONS This form, when duly signed and notarized, must be filed with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 32317-5709; physi- cal address: 325 John Knox Road, Building E, Suite 200, Tallahassee, Florida 32303. The fonm must be filed no later than the last day of the calendar q u a rt e r th a t fo llows 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.) CE FO RM 9- E FF. 1/2016 (Refer to Rule 34-7.010(1)(g), FA.C.) (See reverse side for instructions) @° If y o u h a v e a n y q u e s tio n s re g a rd in g y o u r o rd e r o r u p c o m in g v is it, p le a s e c a ll 3 0 5 .9 4 9 .6 7 2 2 fo r im m e d ia te a s s is ta n c e . Y o u m a y a ls o re p ly to th is e m a il a n d a c u s to m e r se rv ic e re p re s e n ta tiv e w ill b e in to u c h w ith y o u w ith in 2 4 -4 8 h o u rs . Order Number: Date: 5699749 11/3/2022 Email address: Delivery Method: Billing address: kristen@miamibeachflgoy Digital-True Ticket 4618 Alton Road Miami Beach, FL 33140 USA Order Details Ticket Purchase Performance: My Fair Lady Performance Date/Time: Tuesday, March 28, 2023 8:00 PM ZIFF BALLET OPERA HOUSE Tier 1 Box Left: Box 15, Seat 3; Box 15, Seat 4 2 Group-Bundle @ $130.00 $260.00 ORDER TOTAL Subtotal: $260.00 2223 BWY Group Fee >$32.99: $10.00 Total: $270.00 Please Arrive Early Late seating is not guaranteed and will only be allowed at the discretion of the House Managers with permission of artist management. All guests entering the premises will be asked to pass through a metal detector and will be subject to bag checks. Please allow extra time for this new process in your plans. Click here for a list of prohibited items. Your safety is our top priority, and your patience is appreciated. Please visit our Center Policies page for more information. Getting to the Arsht Center 2 Please visit our Getting Here section of the website for directions, parking, public transportation and traffic advisories for the day of your performance. More helpful links: Plan Your Visit Frequently Asked Questions General Theater Policies Adrienne Arsht Center for the Performing Arts of Miami-Dade County 1300 Biscayne Blvd. Miami, FL 33130 Box Office: 305.949.6722 3 C it y C le r k USPS CERTIFIED MAIL I 11 111 9214 8901 9403 8320 2318 03 FLORIDA COMMISSION ON ETHICS PO BOX 15709 TALLAHASSEE FL 32317-5709 Fold Her e Return Reference Number: Username: Charles Dagostin Code Violation # : Court Case #: Property Address :: Permit ID#: Custom 5: Postage: $7 .0900