Alex Fernandez Form 9 QTR II,·"BE A CH //\ HA//\l tt
O FFIC E O F TH E C ITY C LERK
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, FL 33139
www.miamibeach!l.gov
Telephone: 305.673.7411
September 30, 2022
Florida Commission on Ethics
P.O. Drawer 15709
Tallahassee, FL 32317-5709
Pursuant to Sec. 112.3148, Florida Statutes, please find Quarterly Gift Disclosure State Form
(9), for the quarter ending June 2022, for the following City of Miami Beach Personnel:
• Alex Fernandez - Vice-Mayor
• Steven J. Meiner - Commissioner
• Kristen Rosen Gonzalez - Commissioner
• David L. Richardson - Commissioner
Should you have any questions or require any additional information, please contact me at
305.673. 7 411.
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City Clerk
Attachment
Sent Certified Return Receipt
City Clerk
1700 Convention Center Drive
Miami Beach FL 33139
USPS CERTIFIED MAIL
II 11111111 1111
9214 890194038391419360
FLORIDA COMMISSION ON ETHICS
PO BOX 15709
TALLAHASSEE FLORIDA 32317-5709
Fold Here
Return Reference Number:
Username: Patrick Camm
Code Violation # :
Court Case #:
Property Address : :
Permit ID#:
Custom 5:
Postage: $6.8100
Fo rm 9 QUARTERLY GIFT DISCLOSURE
(GIFTS OVER $100)
LAST NAME -- FIRST NAME -- MIDDLE NAME: NAME OF AGENCY
F em an dez, A lex C ity of M iam i B each
MAILING ADDRESS: OFFICE OR POSITION HELD:
170 0 C o nv en tion C en ter D rive C o m m issio ner
CITY: ZIP: COUNTY: FOR QUARTER ENDING (CHECK ONE): YEAR
M iam i B each 33 139 M iam i-D ad e JMARCH JUNE □SEPTEMBER □DECEMBER 20 -
PART A- STATEMENT OF GIFT 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 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 TH E GIFT MAKING TH E GIFT
See Attached See Attached See Attached See Attached See Attached
} 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.
D 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,
STATE OF FLORIDA
COUNTY OF D-ALA±fl- p0&
Sw or/to (or affirm ed) and sub scribed before me by mean s of
(}ph ysical presence or [] online notarization, this
3Ci dayof Se 2o_2-- 46
Public-State of Florida)
(Print, Type, or Stamp C missioned Name of Notary Public)
Personally Known ' OR Produced Identification
Type of Identification Produced
PART D FILI NG 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 (Ref e r to Rule 34-7.010(1)(g9), F.A.C.) (See reverse side for instructions) @"
D a t e D e s c r ip tio n o f G ift M o n e ta ry N a m e o f P e rs o n A d d re s s o f P e rs o n
R e c e iv e d V a lu e M a k in g th e G ift M a ki n a th e Gi f t
04/06/2022 Bitcoin 2022 $2,399 X 2 BTC contact@btcmedia.org
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Beach Affair Suite 210
04/09/2022 2022 Kristi House's Annual $500 Kristi House Four Seasons, 1435
Gala- A Night in the Brickell Avenue, Miami,
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04/10/2022 Miami Beach Pride $250 X 2 Miami Beach Pride 1210 Washington Ave
Parade Suite 21 0
04/14/2022 Better Beach Awards Minimum of Miami Beach 1920 Meridian Ave,
$100.00 Chamber of Miami Beach, FL 33139
Commerce
05/05/2022 Carbone on the Beach $3000.00 X 2 Major Food Group lile mj4Joos .e on
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20037
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Tank Laboratory 4600 Rickenbacker
Causeway
Miami, FL 33149
05/10/2022 Aspen Conference: $150 X 2 The Aspen Institute 2300 N Street, NW Suite
Aspen Ideas Climate 700, Washington, DC
Dinner at HaSalon 20037
06/12/2022 Michelin Star Launch Minimum of GMCVB 701 Brickell Ave #2700
Event $100.00 X 2