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Jessica Lorenzo & Christian Camacho County Form QTR IMIAMIB H JUN 0 7 2024 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 7, 2024 Miami-Dade Clerk of the Board of County Commissioners 111NW 1Street, # 17-10 Miami, FL 33128 Pursuant to Section 2-11.1( e )( 4) of the Code of Miami-Dade County, attached please find a copy of the Miami-Dade County Quarterly Gift Disclosure Form, for the quarter ending December 2023, for the following City of Miami Beach Personnel: Jessica Lorenzo - Environmental & Sustainability Environmental Specialist (City of Miami Beach) Christian A. Camacho - Forestry Field Specialist (City of Miami Beach) The original has been filed with the Miami Beach Office of the City Clerk. Should you have any questions or require any additional information, please contact me at 305.673. 7 411. 5# Rafael E. Granado, City Clerk Attachments REG:cd Sent Certified Return Receipt MIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME-FIRST NAME-MIDDLE NAME: NAME OF AGENCY: C44cho,C's+« 4 CC'} o} car; Bea«ch STREE ADDRESS: OFFICE OR POSITION HELD: [7oo ta,vent.a el D Hores}ts4 :ell 5e'al.'st CITY: /{on' Be«ch FOR QUARTER ENDING (Check One): ZIP: 3213.FL 3 ~ARCH □JUNE COUNTY: 1,a. D ol oonly □SEPT. □DEC. YEAR: 202'L t PART A: STATEMENT 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 MONETARY NAME OF PERSON ADDRESS OF PERSON RECEIVED OF GIFT VALUE MAKING THE GIFT MAKING THE GIFT 3/4/20/ \5pea 500.0o $ [hl %e tows+.:/tc 23'0» w.5±, Aw I so.le 700 vw/a« «q to B , 200 37 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: 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, 1HI NW I" St., Suite 17-10, Miami, FL 33128. Municipal personnel file with their respective municipal clerks. PART D: 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.l (e)(4) of the Code of Miami-Dade County. sor or "q/!/% a46 COUNTY OF Omni }W? to (or affirmed) and subscribed before me this 3day of(Joe, .2og9 by.' .- .Cao\O rson Making Gift Disclosure) Signature of Person Making Gift Disclosure ALIOE O. LAVADO MY COMMISSION #HH272560 om re. or sun Conni.aa ll Ml.d, a, pxPInES: JUN 06, 2026 t Bonded through 1st State Insurance ersonally known to me or [] Produced lden#cation' ype of Identification Produced. COE 02/2010 MIAMI-DADE COUNTY QUARTERLY GIFT DISCLOSURE LAST NAME-FIRST NAME-MIDDLE NAME: o M STREE ADDRESS: 700 oV# Ch R POSITION HELD; ., 4u "J crTY: Mi'oni' 'ah z. 33134 COUNTY: MARCH DJ JUNE SEPT. DDEC. YEAR: 202± PART A: STATEMENT 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 RECEIVED DESCRIPTION OF GIFT MONETARY VALUE NAME OF PERSON ADDRESS OF PERSON MAKING THE GIFT MAKING THE GIFT 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: 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, 11I NW I St., Suite 17-10, Miami, FL 33128. Municipal personnel file with their respective municipal clerks. PART D: 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. STATE OF FLORIDA I') COUNTY or Hon Bod<_ gn to (or affirmed) and subscribed before me this Nay or5on° .2024 . ». ·o Loe2o son Making Gift Disclosure) tatc of Florida) /ee •Load.g2.. @it, Type, or Samp ComniiissioT $aa.a. Gr Roary Public) D Personally known to me or DJ Produced Identification Tye or Id~nitication Produced:_,5-4a0--9q(32 COE02/2010 a ALICE S. LAVADO I' MY COMMISSION #HH272560 EXPIRES: JUN 06, 2026 Bonded through 1st State Insurance City of Miami Beach City Clerk 1700 Convention Center Dr Miami Beach FI 33139 USPS CERTIFIED MAIL I 11111 Ill 9214 8901 9403 8365 0950 57 MIAMI-DADE CLERK OF THE BOARD OF COUNTY COMMISSIONERS 111NW 1ST ST UNIT 17-10 MIAMI FL 33128-1902 Fold Here Return Reference Number: Username: Gabriel Donadio Martins Code Violation # : Court Case #: Property Address : : Permit ID#: Custom 5: Postage: $7.3600