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David Richardson Form 9 QTR IMIAMI 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 June 29, 2022 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 March 2022, for the following City of Miami Beach Personnel: • David Richardson — Commissioner (City of Miami Beach) Should you have any questions or require any additional information, please contact me at 305.673.7411. Respectfully, RafaI E. Granado, City Clerk Attachment REG:cd Sent Certified Return Receipt Form 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGENCY: Richardson -Lance -David City of Miami Beach MAILING ADDRESS: OFFICE OR POSITION HELD: 1700 Convention Center Drive City Commissioner, Group 6 CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR Miami Beach 33139 Miami -Dade P$AARCH ❑JUNE ❑SEPTEMBER LlDECEMBER 20-22 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 02/11/2022 Opening Night of "Swan Lake" (2 tickets total: 1 ticket used for self, l ticket to food distribution p $380.00 Miami City Ballet 2200 Liberty Avenue, given volunteer) Miami Beach, FL. 33139 02/24/2022 South Beach Food & Wine Festival (4 tickets received I for 3 $/7 00.00 City of Miami Beach 1700 Convention Center Dr., per city contract: ticket used self, tickets given to food distribution volunteers, per city contract) Miami Beach, FL. 33139 02�25�2022 South Beach Food & Wine Festival (2 tickets received city contract; I tickets for self. l $350.00 City of Miami Beach 1700 Convention Center Dr., per used ticket given to food distribution volunteer) Miami Beach, FL. 33139 02/2 6�2022 South Beach Food & Wine Festival (2 tickets both food $350.00 City of Miami Beach 1700 Convention Center Dr., received per city contract; given to Miami Beach, FL. 33139 distribution volunteers) C� 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 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, Florida Stat es. SIGNATU REPOR`fIN OFFICIAL STATE OF FLORIDA COUNTY OF @yprn to (or affirmed) and subscribed before me by means of y ica resence or Q on a notarization, this /Z� day of _ I � 20 by /)K V0 X1' (Print, Type, or Stam C 1 Personally Known Type of Identification Produced PART D — FILING INSTRUCTIONS MY COMMISSION # HH 165705 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) FORM 9 — Richardson — Lance — David PART A — STATEMENT OF GIFTS (Continued) DATE DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF RECEIVED OF GIFT VALUE MAKING THE GIFT PERSON MAKING THE GIFT 03/18/2022 (2 tickets at $65 $130.00 Miami New 1040 Lincoln each; 1 ticket Drama/Colony Road, Miami used for self, 1 Theatre Beach, FL. 33193 ticket given to food distribution volunteers) City Clerk 1111111IIII11111IIII1 111111111111111111NIIIIIIIN 9214 8901 9403 8381 0199 76 FLORIDA COMMISSION ON ETHICS PO BOX 15709 TALLAHASSEE FL 32317-5709 Return Reference Number:David Richardson Gift Disclosure Username: Charles Dagostin Code Violation # Court Case #: Property Address Permit ID #: Custom 5: Postage: $6.1300