Michael Gongora Form 9 March 2020 RevisedMI AB I BEACH
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www._miamibegchfl_goy
Telephone: 305.673.7411
March 10, 2021
Florida Commission on Ethics
P.O. Drawer 15709
Tallahassee, FL 32317-5709
Pursuant to Sec. 112.3148, Florida Statutes, please find Amended Quarterly Gift Disclosure
State Form (9), for the quarter ending in March 2020, for the following City of Miami Beach
Personnel:
• Michael Góngora - Commissioner
Should you have any questions or require any additional information, please contact me at
305.673. 7 411.
P y 7.3 Rafael E. Granado
City Clerk
Attachment
Sent Certified Return Receipt
F:\CLER\$ALL\GIFT DISCLOSURES\Template 2020\MASTER FOR THE STATE - REG1.docx
H HE DED
Form 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGENCY:
Góngora Michael City of Miami Beach
MAILING ADDRESS: OFFICE OR POSITION HELD:
1700 Convention Center Drive Commissioner
CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR
Miami Beach 33139 Dade M AR CH □JUNE □SEPTEMBER O DECEMBER 20 20
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
01/13/2020 Main Event $118 Miami Jewish Miami,FL
Federation
2/10/2020 Barilla's Italian Bites on $225 South Beach Wine Miami,FL
the Beach and Food Festival
2/10/2020 Burger Bash $350 South Beach Wine Miami,FL
and Food Festival
2/10/2020 Goya Foods' Grand $275 South Beach Wine Miami,FL
Testing and Food Festival
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.
O 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
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,
WCI »
#:7 #7•
STATE OF FLORIDA
COUNTY OF tiAtl - D E
Sworn to (or affirmed) and subscribed before me by means of
Lg}6hysical presence or [} online notarization, this ,d .dayof r ace _.201 l <±s
t
by _rç9EL Caco+o
ublic-State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known y_ 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. 1/2016 (Refer to Rule 34-7.010(1 )(g), F.A.C.) (See reverse side for instructions) e°
Table 1
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Date Received Description of Gift Monetary Value Name of Individual Address of I i
Individual Giving
Gift I
!
! 2/10/2020 Beachside BBQ $225.00 South Beach Wine Miami, FL ' l ! ! and Food Festival
2/20/2020 Bass Museum Ball $1,500.00 Bass Museum Miami Beach, FL ' j
01/14/202 0 New Order Tickets 2 at $78.50 each for The Fillmore Miami Miami Beach, FL '
total of $157.00 Beach I
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City Clerk
1700 Convention Center Drive
Miami Beach FL 33139
USPS CERTIFIED MAIL
I 11 1 1 1 1111
9214 8901 9403 8334 0640 60
FLORIDA COMMISSION ON ETHICS
PO BOX 15709
TALLAHASSEE FLORIDA 32317-5709
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Usern am e: Patrick Cam m
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