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David Richardson QTR IV Form 9O FF IC E O F T H E C ITY C L E R K C ity o f M ia m i B e a ch , 17 0 0 C on v en t i on C e n te r D riv e , M ia m i B e a c h , F L 3 3 1 3 9 www .m ia m ib e a c h fl .g o v T e le p h o n e : 3 0 5 .6 7 3 -7 4 1 1 December 04, 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 December 2023, for the following City of Miami Beach Personnel: • David Richardson - Commissioner (City of Miami Beach) Should you have any questions or require any additional information, please contact me at 305.673. 7411. Respectfully, Rafael E. Granado, City Clerk Attachment REG:cd Sent Certified Return Receipt Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LA ST NAME -- FIRST NAM E -- MI DDLE NAME: NAME OF AGENCY Richardson-Lance-David City of Miami Beach MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 C o n v en tion C enter Drive City Comm issioner, Group 6 CITY : ZIP: COUNTY : FOR QUARTER ENDING (CHECK ONE): YEAR M iam i B each 3313 9 M iam i-D ad e □MARCH JUNE □SEPTEMBER 0ECEMBER 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 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 10/01/2023 "Golden Anniversary Gala" (I $150.00 The Animal Welfare 2601 SW 27th Avenue, ticket used for self) Society of Florida Miami, FL 33133 10/07/2023 Cuban Association of Civil Engineers $250.00 CES Consultants, Inc. 880 SW 145th Avenue, "Engineer's Day" Gala (! ticket used for self) Pembroke Pines, FL 33027 10/13/2023 "Cherry Blossom Sky Gala"(! $1,000.00 Dr. Doug Hornsby and 2412 County Club Prado ticket used for self) Sissy Shute Coral Gables, FL 33134 10/14/2023 National LGBTQ Task Force Gala $1,000.00 City of Miami Beach 1700 Convention Center Drive, (2 tickets total) Miami Beach, FL 33139 ~ CHECK HERE IF CONTINUED ON SEPARATE SHEET PART B RECEIPT PROVIDED BY PERSON MAKING THE GIFT If any receipt for a gift listed above was provided to you by the person making the gift, you are required to attach a copy of that receipt to this form. You may attach an explanation of any differences between the information disclosed on this form and the information on the receipt. □CHECK HERE IF A RECEIPT 15 ATTACHED TO THIS FORM PARTC-OATH I, the person whose name appears at the beginning of this form, do depose on oath or affirmation and say that the information disclosed herein and on any attachments made by me constitutes a true accurate, and total listing of all gifts required to be reported by Section 112.3148, sore oroso,- [)AD)~ couNror 1 y/M p- , )JI or affirmed) and subscribed before me by means of ence or nline notariz tion, this ~3 1/ll _ _,20do 1 , _C· atur0_ f Notary Public-State of Florida) f$AC [aT] seeper=pee = n3 ) , .i' 2Ex».. CHARLES J. DAGOST (Print, Type, or Stamp Commissi s¥ '~j ot#y COMMISSION # HH 1$5705 Personally Known _ OR Pr4 zfJica/PIRES: December 14, t025 Type of Identification Produced :;%°' jrwriters PART D FILING 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 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.) CE FORM 9-EFF 1/2016 (Refer to Rule 34-7.010(1)g), FA.C.) (See reverse side for instructions) 9" FO R M 9- Rich ardso n - Lanc e - D avi d O cto b e r, N o ve m ber, D e ce m b e r 2023 PA R T A -S T A T EM EN T O F G IFT S (C o ntin ue d ) D A T E D ESCR IPT IO N M O N ETA RY N A M E O F PER SO N A D DRESS O F R EC EIV ED O F G IFT V A LU E M A KIN G TH E GIFT PER SO N M A K ING TH E G IFT 10/20/2023 M ia m i City Balle t $468.00 M iam i City Ballet 2200 Libert y Se ason O p en ing A venue, M iam i Perf orm ance (2 Beach, FL 3313 9 tic kets to tal, 1 fo r se lf, an d 1 fo r fo o d distributio n vo lun teer) 10/24/2023 3" An nu al C -N o te $200.00 City of M iam i 1700 Co nvention D inn er in su ppo rt Beach Center D rive, of the City's M iam i Beach, FL Breast C an ce r 33139 A w areness M o nth (2 ti ckets, 1 fo r se lf, an d 1 fo r fo o d distribu tio n vo lun teer) 10/30/2023 G ift of Life $1000.00 City of M iam i 1700 Co nvention Fo u n d atio n "O n e Beach Center D rive, H ug e N ig h t M iam i M iam i Beach, FL G al a" (1 tick e t fo r 33139 se lf) 11/02/2023 T he Rh ythm $425.00 C ity of M iam i 1700 Conventio n Fo und atio n G ala Beach Center Drive, (1 tic ket fo r se lf) M iam i Beach, FL 33139 City Clerk USPS CERTIFIED MAIL 11111111 I 9214 8901 9403 8340 7047 76 FLORIDA COMMISSION ON ETHICS PO BOX 15709 TALLAHASSEE FL 32317-5709 Fold Here Return Reference Number: Username: Charles Dagostin Code Violation # : Court Case #: Property Address :: Permit ID#: Custom 5: Postage: $7.4200