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David Richardson 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. "} .~.-.a 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 F o rm 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LAST NAME -- FIRST NAME -- MIDDLE NAME NAME OF AGENCY: Richardson-Lance-David Citv 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 □MARCH JUNE SEPTEMBER O 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 DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF PERSON RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT 04/09/2022 Ancient Spanish Monastery Foundation 8th Legacy $550.00 Greater Miami Convention 701 Brickell Avenue, Suite Gala (2 tickets total ; I ticket used for self, I tick et for aide) and Visitor's Bureau 2700, Miami, FL. 33131 05/06/2022 Carbone Dinner (2 tickets total. I ticket used for $6,000.00 Carbone Major Food Group 49 Collins Avenue, Miami self, I ticket used for food distribution volunteer) Beach, FL. 33139 05/09/2022 Informed Families (I tickets used $100.00+ Informed Families 12490 Coral Way, 3rd Floor for self) Miami, FL 33145 05/12/2022 Opening Nigh t of "Th e Cuban Vote" (2 tickets $200.00 The Colony Theatre 1040 Lincoln Road, Miami total; I ticket used for self, I ticket for food distribution volunteer) Beach, FL. 33139 ~ 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. O 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, Florida Statutes. 2,,%.9'0w4 ± Me ?yorn to (or affirmed) and subscribed before me by means of IAtphy~ presence or Don!~ i:;ot~ization, this 1? .d yof T .202d ]pg , D, as (Print, Type, or Stamp C missioned Name of Notary Public) Personally Known OR Produced Identification Type of Identification Produced -' PART D - FILING INSTRUCTIONS (Signature of Notary Public-State of Florida) Me o So 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.) C E FO RM 9 - EF F. 1/2016 (Refer to R ul e 34-7.010(1)(g) F A.C .) (See revers e side for instructions) @# FORM 9 - Richardson- Lance - David April, May, June 2022 PA RT A - STATEM ENT OF G IFTS {Continued) DATE DESCRIPTION MONETARY NAME OF PERSON ADDRESS OF RECEIVED OF GIFT VALUE MAKING THE GIFT PERSON MAKING THE GIFT 05/19/2022 Association of $100.0 0+ Miami-Dade P.O. Box 531045, Chief's of Police County Miami Shores, FL Dinner (1 ticket Association of 33153 total) Chiefs of Police 05/22/2022 South Beach Jazz $120.0 0 Power Access/ 919 Washington Festival Honors South Beach Jazz Avenue, Miami and Awards Festival Beach, FL. 3313 9 Brunch (1 ticket total) 05/28-29/20 22 Hyundai Air & Sea $100.00+ City of Miami 1700 Convention Sho w (2 tickets, 1 Beach Center Drive, for self, and 1 for Miami Beach, FL. food distribution 3313 9 volunteer) 06/12/2022 MICHELIN: $100.0 0+ Greater Miami 701 Brickell Greater Miami Convention and Avenue, Suite Event 2022 (1 Visitor's Bureau 2700, Miami, FL. ticket for self) 3313 1