Michael Gongora - December 2011 Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME—FIRST NAME—MIDDLE NAME: NAME OF AGENCY:
GONGORA, MICHAEL CITY OF MIAMI BEACH
MAILING ADDRESS: OFFICE OR POSITION HELD:
1700 CONVENTION CENTER DRIVE COMMISSIONER
CITY: ZIP: COUNTY: FOR QUARTER ENDING(CHECK ONE): YEAR
MIAMI BEACH, FL 33139 DADE ❑MARCH ❑JUNE ❑SEPTEMBER DECEMBER 201L
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 fads,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 AD6_SESSj, PERSON
RECEIVED OF GIFT VALUE MAKING THE GIFT M7 KINC;Z�E GIFT
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SEE ATTACH D N
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❑ 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 IS ATTACHED TO THIS FORM
PART C—OATH
I,the person whose name appears at the beginning of this form,do STATE OF FLORID
COUNTY OF (JQ(J
depose on oath or affirmation and say that the information disclosed Swor to Tti of firmed)and sug.p_cribed before me this
day of 1"noA2 rh 20�
herein and on any attachments made by me constitutes a true accurate,
by
and total listing of all gifts required to be reported by Section 112.3148, t
Florida Statutes4REPORTI (Signature of Notary Pub i -Sta e of Florida)
(Print,Type,or Stamp Coy s' of to -
G A URE FIC IAL Personally Known c ebb of
Type of Identification Produ W" 4t
PART D—FILING INSTRUCTIONS 111admThM0111BD�Iliory
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:3600 Maday Blvd.South,Suite 201,Tallahassee,Florida 32312.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. 1/2007 (See reverse side for instructions)�°
FORM 9 QUARTERLY GIFT DISCLOSURE
(ATTACHMENT)
RE: Commissioner Michael Gongora
Ticket Distribution for October—December 2011
City of Miami Beach Mayor and Commission Office
DATE EVENT VALUE
Oct. 2 Camila
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $98.50 ea. $197.00
Oct. 8 Andres Calamaro
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $63.50 ea. $127.00
Oct. 15 Giselle
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2.tickets @ $60.00 ea. $120.00
Oct. 15 Nat'l Gay & Lesbian Task Force Gala
Provided by City of Miami Beach
Miami Beach, FL 33139
2.ticket @ 200.00 ea. $400.00
Oct. 22 Miami Arts Gala
Provided by City of Miami Beach
Miami Beach, FL 33139
2 ticket @ 3 00.00 ea. $600.00
Oct. 22 Miami City Ballet Program I
Provided by City of Miami Beach
1100 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $85.00 ea. $170.00
Oct. 28 Miami International Auto Show
Provided by City of Miami Beach _
1700 Convention Center Dr.
Miami Beach, FL 33139
10 tickets @ $10.00 ea. $100.00
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FORM.9 QUARTERLY GIFT DISCLOSURE
(ATTACHMENT)
RE: Commissioner Mi6ael Gongora
Ticket Distribution for October—December 2011
City of Miami Beach Mayor and Commission Office
DATE EVENT VALUE
Nov.l David Sedaris
Provided by City of Miami Beach
17010 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $50.00 ea. $100.00
Nov.l l Maria Bethania
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2'tickets @ $80.00ea. $160.00
Nov.12 Sting
Provided by City of Miami Beach
1.700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $86.50ea. $173.00
Nov.13 Sting,
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $86.50ea. $173.00
Nov.18 Bikini Physique Prejudging
Provided by City of Miami Beach
1700,Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $53.50ea. $107.00
Nov.19 Bikini Physique Finals
Provided by City of Miami Beach
1.700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $78.50ea. $157.00
Nov.23 Tigger (short film)
.Provided by City of Miami Beach
17,66 Convention Center Dr.
Miarni Beach, FL 33139
.-tickets @ $55.00ea. $110.00
FORM 9 QUARTERLY GIFT DISCLOSURE
(ATTACHMENT)
RE: Commissioner Michael Gongora
Ticket Distribution.for October—December 2011
City of Miami Beach Mayor and Commission Office
DATE EVENT VALUE
Nov.26 Tracy Morgan Live
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $63.50ea. $127.00
Nov.27 The Kings of Salsa
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 ti>✓kets @ $58.50ea. $117.00
Dec.01 Enrique Bunbury
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $73.00ea. $146.00
Dec.02 Sleepless Night Cafe Bustelo box
Provided by City of Miami Beach
1.700 Convention Center Dr.
Miami Beach, FL 33139
1 box @ $l 00.00ea. $100.00
Dec.03 Daniel Levi
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $50.00ea. $100.00
Dec.03 Jean-Carlos Canela
Provided by City of Miami Beach
1700 Convention-Center Dr.
Miami Beach, FL 33139
2 tickets @ $78.25ea. $156.50
Dec.05 Janet Jackson
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $116.5 Oea. $233.00
FORM 9 QUARTERLY GIFT DISCLOSURE
(ATTACHMENT)
RE: Commissioner Michael Gongora
Ticket Distribution for October—December 2011
City of Miaini Beach Mayor and Commission Office
DATE EVENT VALUE
Dec.10 Bikini & Masters Prejudging
:Provided by City of Miami Beach
.4.700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $60.00ea. $120.00
Dec.10 Showdown
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $100.00ea. $200.00
Dec.16 Celine Dion Event
Provided by City of Miami Beach
1700..Convention Center Dr.
Miami Beach, FL 33139
•2 tickets @ $1000.00ea. $2000.00
Dec.17 The Nutcracker
Provided by City of Miami Beach
1700,Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $58.00ea. $116.00
Dec.20 Woody Allen Jazz Band
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $125.00ea. $250.00