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Diana Fontani County FormMIAMI 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 September 30, 2019 Miami-Dade Clerk of the Board of County Commissioners 111 NW 1St Street, # 17-10 Miami, FL 33128 Pursuant to Section 2-11.1(e)(4) of the Code of Miami-Dade County, attached please find a copy of the Miami-Dade County Quarterly Gift Disclosure Form, for the quarter ending June 2019, for the following City of Miami Beach Personnel: Diana Fontani Martinez— City of Miami Beach (Commission Aide) The original has been filed with the Miami Beach Office of the City Clerk. Should you have any questions or require any additional information, please contact me at 305.673.7411. Respectfully, ael E. Granado, la. City Clerk Attachments REG:cd Sent Certified Return Receipt MIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: Fontani Martinez, Diana City of Miami Beach STREE ADDRESS: OFFICE OR POSITION HELD: 1700 Convention Center Drive Aide to Commissioner CITY: Miami Beach FOR QUARTER ENDING(Check One): ZIP: 33139 MARCH Q JUNE COUNTY: Miami Dade SEPT. 0 DEC. YEAR:2019 PART A: STATEMENT OF GIFTS.List below each gift,or series of gifts,from one person or entity in excess of$100,accepted by you during the calendar quarter for which this statement is being filed.Describe the gift and state the monetary value of the gift,the name and address of the person making the gift,and the dates the gifts were received.If any of these facts are unknown or not applicable,state this on the form.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 05/13/2019 Informed Families Fundraiser $200 Erin Dowd 6855 Red Road,Suite 500 Coral Gables,FL 33143 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.0 PART C: FILING INSTRUCTIONS.The signed and notarized form must be filed no later than the last day of the calendar quarter that follows the quarter for which this form applies.For example,if a gift is received in March, it should be disclosed by the end of the next quarter,i.e.,June 30.County personnel file with the Clerk of the Board of County Commissioners, 111 NW 1"St.,Suite 1:7-10,Miami,FL 33128.Municipal personnel file with their respective municipal clerks. PART D: OATH. I, the person whose name appears at the beginning of STATE OF FLO A Q this form, do depose on oath or affirmation and say COUNTY OF Qm'l— ` a.eZe that the information disclosed herein and on any attachments made by me constitutes a true, accurate, orn to(or armed)a d subscribe before me this and total listing of all gifts required to be reported by 0 day of-A24) 20 1 Section 2-11.1 (e)(4) of the Code of Miami-Dade I nty. b &.h1 - of Person Disclosure) f Si aloe of .. Publi,State of Florida) Sign• e s son Making Gift Disclosure 1 i QJ? f int,Type,or Stamp Commissioned Name of Notary Public) Personally known to me or 0 Produced Identification Type of Identification Produced: rn' "•. CARMEN B.HERNANDEZ MY COMMISSION#GG 208676 COE 02!2010 7.1 EXPIRES:August 3,2022 Bonded Thru Notary Public Underwriters USPS CERTIFIED MAIL 4203312819029214890194038391232648 9214 8901 9403 8391 2326 48 City of Miami Beach City Clerk 1700 Convention Center Dr Miami Beach Fl 33139 MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS 111 NW 1ST ST UNIT 17-10 MIAMI FL 33128-1902 Return Reference#: Username: Charles Dagostin Postage: $5.6000 Code Violation # : Court Case #: Property Address :: Permit ID #: Custom 5: Fold Here___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________