Michael Gongora Form 9 LastM IA M I BEA C H
O FFIC E O F TH E C ITY C LERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachf],gov
Telephone: 305 .673 .7 411
December 30, 2021
ECEIVED
JAN 3 2022
AMI BEACH cm 0EM!}2 hr ciii
or#ICE OF T
Florida Commission on Ethics
P.O. Drawer 15709
Tallahassee, FL 32317-5709
Pursuant to Sec. 112.3148, Florida tatutes, please find Quarterly Gift Disclosure State Form
(9), for the quarter ending May ,, )2, for the following City of Miami Beach Personnel:
Gd>te OO[
• Michael Góngora - Former Commissioner
• Micky Steinberg - Former Commissioner
Should you have any questions or require any additional information, please contact me at
305.673.7411.
"; ••• City Clerk
Attachment
Sent Certified Return Receipt
F:\CLER\$ALL\GIFT DISCLOSURES\Template 2020\MASTER FOR THE STATE - REG1 .docx
BECEivED
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Form 9 QUARTERLY GIFT DISCLOSURE CI T Y O F MI AM I BE A CH (GIFTS OVER $100) OFFICE OF THE CITY C LEF
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 QUARTFR ENDING (CHECK ONE YEAR
Miami Beach 33139 County AR CH JNE EP TEMBER / ECE MBER 2024
K
PA R T A - STA T E M E N T O F G IF T S
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 statem ent fo r any calendar quarter during w hich you did not receive a reportable gift.
DATE DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PER SON
RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT
11/17/2021 Ribbon Cutting $100 Matias Pesce 40 SW 13th St
(Colohration Dinner 1HITE 301 Rriclell
at Mercato Della Pescheria
-
CHECK HERE IF CO NTINUED O N SEPARATE SHEET
PA R T B - R E C E IP T PR O V ID E D B Y PE R S O N M A K IN G TH E G IF T
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.
CHE CK HERE IF A RECEIPT IS ATTACHED TO THIS FO RM
PA R T C O A TH
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,
STATE OF FLOR /pA
couNrY or /Ai Lade sot (or affirmed) and sub scribe d before me by means of
LU6nysical presen ce or [] online notarization, this 24. dayoí _eeoe 2o_2]
(Print, Type, or Stamp niters
Personally Known
Type of Identification Produced
PA R T D F ILI N G IN S T R U C T IO N S
This form, when duly signed and notarized, must be filed with the Commission on Ethics, PO. Drawer 15709, Tallahassee, Florida 32317-5709; physi-
cal address: 325 John Knox Road, Building E, Suite 200, Tallahassee, Florida 32303. Th e 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 (Ref er to Rule 34-7.010(1)(9), F.A.C.) (See reverse side for instructions) @
City Clerk
1700 Convention Center Drive
Miami Beach FL 33139
USPS CERTIFIED MAIL
I 1111111 11
9214 8901 9403 8362 6823 80
FLORIDA COMMISSION ON ETHICS
PO BOX 15709
TALLAHASSEE FLORIDA 32317-5709
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