Alex Fernandez Form 9 QTR IIIForm 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME -- FIRST NAME -- MIDDLE NAME:
NAME OF AGENCY:
Fernandez Alex
City of Miami Beach
MAILING ADDRESS:
OFFICE OR POSITION HELD:
1700 Convention Center Drive
City Commissioner
CITY: ZIP: COUNTY:
FOR QUARTER ENDING (CHECK ONE): YEAR
Miami Beach 33139 Miami -Dade
❑MARCH ❑JUNE `tEPTEMBER ❑ DECEMBER 2022
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
RECEIVED
DESCRIPTION
OF GIFT
MONETARY
VALUE
NAME OF PERSON
MAKING THE GIFT
ADDRESS OF PERSON
MAKING THE GIFT
PLEASE
SEE
THE
ATTACHED
SHEET
(W 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 IFA RECEIPT IS ATTACHED TO THIS FORM
PART C - OATH
I, the person whose name appears at the beginning of this form, do STATE OF FLO D j 1,
COUNTY OF 1� (�-%�'®c�n�
depose on oath or affirmation and say that the information disclosed Sw m to (or affirmed) and subscribed before me by means of
�hysi al presence or ❑ nline notarizatjon, this
herein and on any attachments made by me constitutes a true accurate, � � day of Gtr/'\!= , 20
and total listing of all gifts required to be reported by Section 112.3148, by
Florida
(Si • nature of Notary
% C
J- HARLES J.DAGOSt
SIGNATU OFR TINGOFFICI '" ' Ayes' ��'� ISSIad#HH1
(Print, Type, or Stargp Pommissi n �3a of otaEONS) December 14,
Personally Known _ OR Pr is ThruNO YW&Unt
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) ""
Date
Received
Description of Giff
Monetary
Value
Name of Person
Making the Gift
Address of Person Making
the Gift
07/14/2022
Miami Swim Week The Shows
$150 x 2
Jonathan Babicka
799 Brickell Plaza
2022
Executive Director
Suite 801
The Little Lighthouse
Miami, FL 33131
Foundation
09/10/2022
SAVE Champions of Equality
$200 x 2
Orlando Gonzales,
1 101 Brickell Ave, South
2022 Gala
Executive Director,
Tower, 8th Floor, Miami, FL
SAVE
33131
OFFICE OF THE CITY CLERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeachfl.gov
Telephone: 305,673-7411
December 30, 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 September 2022, for the following City of Miami Beach Personnel:
• Alex Fernandez— City Commissioner (City of Miami Beach)
Should you have any questions or require any additional information, please contact me at
305.673.7411.
Respectfully,
/7afael E. Granado,
City Clerk
Attachment
REG:cd
Sent Certified Return Receipt
City of Miami Beach USPS CERTIFIED MAIL
City Clerk
1700 Convention Center Dr
Miami Beach FI 33139
9214 8901 9403 8399 8996 90
FLORIDA COMMISSION ON ETHICS
PO BOX 15709
TALLAHASSEE FL 32317-5709
Fold Here
Return Reference Number:Alex Fernandez Gift Disclosure
Username: Keila Mena Caceres
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