Michael Gongora Form 9 QTR III 2013 •
•
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 ENDI (CHECK ONE): YEAR
MIAMI BEACH, FL 33139 DADE OMARCH OJUNE EPTEMBER 0 DECEMBER 20%3
•
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 A6DRE9g)F PERSON
RECEIVED OF GIFT VALUE' MAKING THE GIFT -MAKIN rHE GIFT
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SEE ATTACHED •
❑ 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 reigjgt,a ��
❑ CHECK HERE IF A RECEIPT IS ATTACHED TO THIS FORM
H .
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PARTC—OATH w ° o
•I,the person whose name appears at the beginning of this form,do STATE OF FLO D o c, x c
g g COUNTY OF ® d o a W y
depose on oath or affirmation and say that the information disclosed Swom to(or aft ed)ands ibed®®b�eeffor a this a a E E
a• day of gi.9'�/ er ,20 JA w Lcs E
herein and on any attachments made by me constitutes a true accurate, 4 < z
by 41.d �� e'
and total listing of all gifts required to be reported by Section 112.3148, '``,,,,,"'
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Florida Sta� -es. (Signature of Notary Publi tate of Florida) 11I_
I P.A• 1 74 • '45'4 • '
_ (Print,Type,or Stamp Gov. fissioned Name of Notary Public)
S'GNATURE OF REPORT) , OFFICIA Personally Known V OR Produced Identification
Type of Identification Produced
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: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 Michael Gongora
Ticket Distribution for July- September 2013
City of Miami Beach Mayor and Commission Office
DATE EVENT VALUE
7/13/13 Air Suppy
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $83.50 ea. $177.00
7/27/13 • Julio Sabala
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $63.50 ea. $127.00
8/16/13 Priceless Miami Justin Timberlake
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $99.50 ea. $199.00
8/30/13 Bellydance Evolution
Provided by City of Miami Beach
1700 Convention Center Dr. �=
. Miami Beach, FL 33139
2 tickets @ $50.00 ea. $100.00
9/7/13 International Ballet Festival of Miami Table 7 No
Provided by City of Miami Beach
1700 Convention Center Dr.
_.r
Miami Beach, FL 33139 �°
•1 tickets @ $125.00 ea $125700
9/07/13 International Ballet Festival of Miami
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $68:50 ea. $137.00
9/08/13 International Ballet Festival of Miami
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $68.50 ea. $137.00
9/20/13 Tumi Awards Gian Marco
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139.
2 tickets @ $60.00 ea. $120.00
9/28/13 Alejandra Ascarate
Provided by City of Miami Beach
1700 Convention Center Dr.
Miami Beach, FL 33139
2 tickets @ $50.00 ea. $100.00