Dan Gelber Form 9\AIAAAI BEACH
OFFICE OF. THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miarnibeachfl.gov
Telephone: 305.673.7411
March 23, 2018
Florida Commission on Ethics
P.O. Drawer 15709
Tallahassee, FL 32317-5709
Pursuant to Sec. 112.3148, Florida Statutes, please find Quarterly Gift Disclosure State Form
(9), for the quarter ending December 2017, for the following City of Miami Beach Personnel:
• Daniel Gelber - Mayor
• Michael GOngora — Commissioner Group 111
• Philip Louis Levine — Former Mayor
Should you have any questions or require any additional information, please contact me at
305.673/411.
Respectfull
F(*atfael E. Granado,
City Clerk
Attachment
REG:rg
Sent Certified Return Receipt
F;\CLER\$ALL\GIFT DISCLOSURES\MASTER FOR THE STATE - REG.docx
Form 9 QUARTERLY GIFT DISCLOSURE
• (GIFTS OVER $100)
• LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGENCY:
6--rc or r if-) Hrp,
MAILING ADDRESS:
MOMI ci.chm
OFFICE of POSITION HELD:
00 con vr: ry-r ior) c -c rrt-c, Dv- or.1
CITY:. ZIP: COUNTY: • FOR QUARTER ENDING (CHECK ONE). YEAR
Mer. 10i EIMARCH L1JUNE DSEPTEMBER DECEMBER 20 1-1
II I
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
1-IECK 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.
CI 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
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,
SIGNATURE bf-RET5ORTING OFFICIAL
STATE OF FLORIDA
COUNTY OF Nie/41/-00
Sworn to (or affirmed) and subscribed before me this
day of 122 /^6
, 20 /
cs,t ,9-2.
Cciti'l
u,
.t a) • -
by t)41/ CI)
U.1 2
CC
Lll g
4J'
(Signat o Notary''Public-State of Florida)
cc,
..=`,)?.- . • • .9' ,•,',-,
).....„
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known 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: 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. 1/2007 (Refer to Rule 34-7.010(1)(g), F.A.C.)(Rev. 6/2016)
(See reverse side for instructions) ci9-
NAME OF EVENT: Miami ArWeek
DATE OF EVENT: December 8, 2017
LOCATION: The Bass Museum
GIFT: 2 Tickets
VALUE OFGIFT: $5Oeach, Total: $1OO*
PAID BY: The Bass Museum
*Mayor Gelber introductory remarks in regards to an art installation during Miami Art Week and to
NAME OF EVENT: Holiday Gift from Optimum Development
DATE OF EVENT: December 21, 2017
GIFT: Holiday Gift Basket
VALUE OF GIFT: $300.00
PAID BY: Optimum Development