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Jorge Exposito - December 2011 Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: EXPOSITO, JORGE CITY OF MIAMI BEACH MAILINGADDRESS: 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 OSEPTEMBER 9 DECEMBER 20J4 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 stale 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 ADDRESS OF PERSON RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT SEE ATTACH D ❑ CHECK HERE IF CONTINUED ON SEPARATE SHEET �� c (7. PART B-RECEIPT PROVIDED BY PERSON MAKING THE GIFT r- z 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:bf,that reipt�4d this form.You may attach an explanation of any differences between the information disclosed on this form and the informateo on t�e receiP� 13 CHECK HERE IF A RECEIPT 15 ATTACHED TO THIS FORM -n — 'T( N PART C—OATH I,the person whose name appears at the beginning of this form,do STATE OF FLORIDA COUNTY OF QQdQ depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and subscribed before me this r I day of in at)t) 20 /d 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, rida Statutes. (Signature of bl' -S to f Florida) (Print,Type,or Stamp Co--- SIGN TU E OF REPORTING OFF L Personally Known !/ Type of Identification Produc PART D-FILING INSTRUCTIONS This form,when duly signed and notarized,must be filed with the Commission on Ethics,P.O.Drawer 157D9,Tallahassee,Florida 32317-5709;physi- cal address:3600 Maclay 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 Jorge Exposito 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 1 ticket @ 200.00 ea. $200.00 Oct. 22 Miami Arts Gala Provided by City of Miami Beach Miami Beach, FL 33139 1 ticket @ 300.00 ea. $300.00 Oct. 22 Miami City Ballet Program I Provided by City of Miami Beach 1700 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. Miaini.Beach, FL 33139 I 0..tickets @ $10.00 ea. $100.00 FORM-9 QUARTERLY GIFT DISCLOSURE (ATTACHMENT) RE: Commissioner Jorge Exposito 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 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $50.00 ea. $100.00 Nov.l l Maria Bethama Provided by City of Miami Beach 1.700 Convention Center Dr. Miami Beach, FL 33139 2..tickets @ $80.00ea. $160.00 Nov.12 Sting Provided by City of Miami Beach 1700 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 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $78.50ea. $157.00 Nov.23 Tigger(short film) Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $55.00ea. $110.00 FORM 9 QUARTERLY GIFT DISCLOSURE (ATTACHMENT) RE: Commissioner Jorge Exposito Ticket Distfibution for October—December 2011 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE Dec.01 :Enrique Bunbury Provided by City of Miami Beach • 1700 Convention Center Dr. Miami Beach, FL 33139 Z-tickets @ $73.00ea. $146.00 Dec.02 Sleepless Night Cafe Bustelo box Provided by City of Miami Beach 1700 Convention Center Dr. Miami Beach, FL 33139 1 box @ $100.00ea. $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 @ $116.50ea. $233.00 Dec.17 The Nutcracker Provided by City of Miami Beach 1.700 Convention Center Dr. Miami Beach, FL 33139 2 tickets @ $58.00ea. $116.00 FORM 9 QUARTERLY GIFT DISCLOSURE (ATTACHMENT) L RE: Commissioner Jorge Ex posito Ticket Distribution for October— December 2011 City of Miami Beach Mayor and Commission Office DATE EVENT VALUE 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 I