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Rafael Paz County Form QTR IMIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME-FIRST NAME-MI DDLE NAME: NAM E OF AGENCY: Paz, Rafael A. City of Miami Beach STRE E AD DRE SS: OFFICE OR POSITION HELD: 1700 Convention Center Drive City Attorney CITY: Miami Beach FOR QUAR TE R END ING (Check One): ZIP: 33139 I MARCH □JUNE COUN TY : Miami-Dade □SEPT. □DEC. YEAR: 2023 PART A: ST A TEMENT 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 MONE TARY NAME OF PERSON ADDRESS OF PERSON RE CEIVED OF GIFT VAL UE MAK ING THE GIFT MAKING TH E GIFT 2 tickets, Miami Open $300- 500 per ticket PDI Healthcare, Inc. 400 Chestnut Ridge Rd, 3/23/23 Woodcliff Lake, NJ CHECK HERE IF CONTINUED ON SEP ARA TE SHEET. 0 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 A TT ACHED TO THIS FORM. D] 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 17-10, Miami, FL 33128. Municipal personnel file with their respective municipal clerks. PARTD: 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 2-11.1 (e)(4) of the Code of Miami-Dade County. Signature of Person Making Gift Disclosure STATE OF FLORIDA COUNTY OF _Miami-Dade Sworn to (or affirmed) and subscribed before me this zO day of Mc; ,2023 , -- t by Rafael A. Paz ·ure) ~ COE 02/2010 D ' A g o s t i n , C h a r le s From: Sent: To: Su bject: A tt achm ents: Granado, Rafael Wednesday, May 31, 2023 11:33 AM D'Agostin, Charles FW: Quarterly Gift Disclosure - Due June 30, 2023 Miami-Dade County Quarterly Gift_March 2023_EXECUTED.pdf; Form 9 Quarterly Gift Disclosure_March 2023_EXECUTED.pdf Rafael E. Granado, Esq., City Clerk OFFICE OF THE CITY CLERK 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305.673. 7 411 rafaelgranado@miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. From: Granado, Rafael Se n t: Tuesday, May 30, 2023 5:24 PM To: Mena Caceres, Keila <KeilaMenaCaceres@miamibeachfl.gov>; D'Agostin, Charles <CharlesDAgostin@miamibeachfl.gov> Su b ject: FW: Quarterly Gift Disclosure - Due June 30, 2023 Who is doing these? /\;\ 1 f 1\/, l n r: f.\ c·· ~-t v r vii hl.. M.a l Rafael E. Granado, Esq., City Clerk OFFICE OF THE CITY CLERK 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305.673.7411 rafaelgranado@miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. From: Gonzalez, Amada <AmadaGonzalez@miamibeachfl.gov> Sen t: Tuesday, May 30, 2023 4:42 PM To: Granado, Rafael <RafaelGranado@miamibeachfl.gov> C c : Paz, Rafael <RafaelPaz@miamibeachfl.gov> Su b ject: RE: Quarterly Gift Disclosure - Due June 30, 2023 Hi Ralph, 1 A tt a c h e d a re R a fa e l's e x e c u te d S ta te (F o rm 9 ) and Miami-Dade County Quarterly Gift Disclosure forms. I will drop off the County Form to you and mail the State (Form 9) to Commission on Ethics, P.O. Drawer 15709, Tallahassee, Florida 32317-5709. Thanks, t ti Amada Gonzalez, Assistant to the City Attorney OFFICE OF THE CITY ATTORNEY Tel: 305-673-7470 Ext 26607 Fro m : Granado, Rafael <RafaelGranado@miamibeachfl.gov> Sent: Tuesday, May 30, 2023 8:37 AM To: Mayor's Office Staff <MayorsOfficeStaff@miamibeachfl.gov>; Mayor Office Team <MayorsOfficeleam@MiamiBeach.onmicrosoft.com>; Mayor's Office Aides <MayorsOfficeAides@miamibeachfl.gov>; Mayor and Commissioners Office <MayorandCommissionersOffice@miamibeachfl.gov>; Mayor's Office <MAYO Dept@miamibeachfl.gov> Cc: City Clerk's Office <CityClerksOffice@miamibeachfl.gov>; City Attorney's Office <CityAttorneysOffice@miamibeachfl.gov>; City Manager's Office <CityManagersOffice@miamibeachfl.gov>; Office of the Inspector General <OfficeofthelnspectorGeneral@miamibeachfl.gov>; Department Directors <DepartmentDirectors@miamibeachfl.gov>; Division Directors <DivisionDirectors@miamibeachfl.gov>; Assistant Department Directors <Assista ntDepa rtme ntDi recto rs@m ia mi beachfl .gov>; Assistant lJivisio n Di rectors <Assista ntDivision Di rectors@mia mi beachfl.gov>; Executive Staff <ExecutiveStaff@mia m ibeachfl.gov>; Management Team <ManagementTeam@miamibeachfl.gov>; Management Team Assistants <ManagementTeamAssistants@miamibeachfl.gov>; D' Agostin, Charles <CharlesDAgostin@miamibeachfl.gov>; Granado, Rafael <RafaelGranado@miamibeachfl.gov>; Mena Caceres, Keila <KeilaMenaCaceres@miamibeachfl.gov>; Camm, Patrick <PatrickCamm@miamibeachfl.gov>; Granado, Rafael <Rafae1Granado@miamibeachfl.gov> Subject: Quarterly Gift Disclosure - Due June 30, 2023 Im portance: High G o o d m o rn in g , P le a se be rem i nd e d tha t Quarterly Gift Disclosures forms are due on or before June 30, 2023, for th e period of January, February, and March 2023. Y o u m u st re p o rt any gift re ceived fro m an ind ivid u a l or single entity d uring January, February, and/or March 2 023 in excess of $100. Reporting is not required if no gift was received. I ha v e a tta ch e d he re w ith a fo rm en ti tle d "2 0 2 3 Fi n an ci al D iscl osure Filin g R eq u irem e nts" to assist you in de te rm in in g w he the r yo u are req u ire d to fil e the S ta te Q u art erly G ift D isclosu re (F o rm 9) or the M iam i-D ade C o u n ty Q u a rt e rly G ift D is c losu re F o rm . (Note: Elected Officials are required to file Form 9.) Where to file? • F o rm 9 m u st be file d w ith the C o m m ission o n E th ics, P.O . D raw er 15 7 0 9 , T allaha sse e , Florida 32317- 57 0 9 . • Mi am i-D a d e C o un t y Q ua rt e rl y Gift Di scl o su re m u st be file d wi th th e Ci ty Clerk, 1%Fl oor Ci ty H al l. If yo u ha ve a n y q u e stion s, plea se fee l fr ee to co n ta ct m e. R e g a rd s , 2 Rafa el E. Granado, Esq., City Clerk OFFICE OF THE CITY CLERK 1700 Convention Center Drive, Miami Beach, FL 33139 Tel: 305.673.7411 rafaelgranado@miamibeachfl.gov We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. 3 City Clerk USPS CERTIFIED MAIL Ill I 1111111 111 9214 8901 9403 8317 2980 62 MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS 111NW 1ST ST UNIT 17-10 MIAMI FL 33128-1902 F old Here Return Reference Number: Usern ame: Charles Dagostin Code Violation # : Court Case #: Pro perty Address :: Permit ID#: Custom 5: Postage: $6.8500