Kristen Rosen Gonzalez Form 9 QTR 4 • ` MIAMI BEACH
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachfl.gov
Telephone: 305.673-7411
April 5, 2019
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 2018, for the following City of Miami Beach Personnel:
• Kristen Rosen Gonzalez— City of Miami Beach (Commissioner)
Should you have any questions or require any additional information, please contact me at
305.673.7411.
Respectfully,
ct%
F 'afael E. Granado,
City Clerk
Attachment
REG:cd
Sent Certified Return Receipt
9214 8901 9403 8381 0977 69
•
City of Miami Beach USPS CERTIFIED MAIL
City Clerk
1700 Convention Center Dr
Miami Beach FI 33139
9214 8901 9403 8381 0977 69
FLORIDA COMMISSION ON ETHICS
PO Box 15709
TALLAHASSEE FL 32317-5709
Fold Here
Return Reference#: KRG Gift Disclosure
Username:Charles Dagotin
Code Violation#:
Court Case#:
Property Address::
Permit ID#:
Custom 5:
Postage:$5.6000
Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME--FIRST NAME-- MIDDLE NAME: NAME OF AGENCY:
Kristen Rosen Gonzalez City of Miami Beach
MAILING ADDRESS: OFFICE OR POSITION HELD:
4618 Alton Road Commissioner- Group IV
CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONEI: YEAR
Miami Beach 33140 Miami-Dade MARCH ❑JUNE SEPTEMBER 0 DECEMBER 2018
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
10/19/18
Sofitel Bogota Victoria Regia Hotel Accomodations for Keynote ($180 per night)Total: Colombia LGBT Chamber of Commerce Calle 57#10-24 Suite 4040
Speaker far Fair of Opportunities and Diverse Businesses" $900
WETRADE 2018 Bogota DC Colombia 110231
11/17/18 Sports Illustrated Celebrity
Beach Soccer Charity ($100 per ticket)Total:$200 Great American Capital 11100 Santa Monica Blvd,
Partners Los Angeles,CA 90025
11/26/18 VIP Art Basel Card ($150 each card)Total: 236 West 30th Street,6th Floor
$150 Art Basel New York,NY 10001
11/26/18 VIP Design Miami Card ($95 each card)Total:$95
Design Miami 3841 NE 2nd Avenue,Suite 400
Miami,FL 33137
V 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
PARTC—OATH
I,the person whose name appears at the beginning of this form,do STATE OF FLORIDA : •••41-°•`•••".o;•.
COUNTY OF Aictr,;-\-)a. . ,i►17�i: �-
depose on oath or affirmation and say that the information disclosed Sworn to(or affirmed)and subscribed before me this : °,.•
5 day of /gyp r;i ,0", .�,(
herein and-on an attachments made by me constitutes a true accurate, 1` /
/° by l l f S re.n \ -' G 0,-�7. \e 0
and tot' listi of all gifts required to be reported by Section 112.3148, ;
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Flori 2 Statues. r Pa
(Signature of Notary Public-State of Flc-if a •• o 9
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t (Print,Type,or Stamp Commissioned Name of Notary Pglo4)., 1
SIG I TU E 0 - -•RTING OFFICI Personally Known \/ OR Produced Identificatio r N 8
t Type of Identification Produced p
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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)
Date Description of Gift Monetary Value Name of Person Giving Gift Address
11/26/2018 Scope Platinum VIP Card ($200 each card)-Total:$200 Scope 452 Baltic Street,NY 11217
11/26/2018 Bass Museum Bag With Various Art Show Tickets $200 Bass Museum 2100 Collins Ave Miami Beach,33139
Gala Dinner of the Diplomatic Correspondent of Malta in 14/11,Vincenti Building,Strait Street,Valletta,
11/28/2018 Paris-Flight and Hotel Accommodations Flight$620 and Hotel$660 Total:$1280 Malta Council for the Voluntary Sector II-Belta Valletta VLT1432 Malta
12/15/2018 Bass Museum Ball $1,500 per tickert-Total:$1,500 Bass Museum 2100 Collins Ave Miami Beach,33139
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