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Kristen Rosen Gonzalez Form 9 QTR ICity of Miami Beach City Clerk 1700 Convention Center Dr Miami Beach Fl 33139 USPS CERTIFIED MAIL I 111111 1111 9214 8901 9403 8367 8985 02 FLORIDA COMMISSION ON ETHICS PO BOX 15709 TALLAHASSEE FL 32317-5709 Fold Here Return Reference Number: Usern ame: Keila Mena Caceres Code Violation # : Court Case #: Property Address :: Permit ID#: Custom 5: Postage: $7.6000 F o rm 9 QUARTERLY GIFT DISCLOSURE (GIFTS OVER $100) LA S T N A M E -- F IR S T NAM E -- MI D DL E NA M E : NA M E O F A G E N C Y : Rosen Gonzalez Kri sten Citv of M iami Beach M A ILI N G A D D R E S S : OF F IC E O R PO SI TI ON HELD: 1700 Convention Center Drive Comm issioner C ITY : Z IP : C O U N TY : FO R Q UA R TE R EN D IN G (CHECK ON E): YEAR Miam i Beach 33139 FL MARCH JUNE □SEPTEMBER □DECEMBER 2024 PA R T A - STATE M E NT O F G IFT 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 fil e this statem ent fo r 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 01/04/2024 2 Tickets to South Beach exceeds $100 Lori Bakkum 1755 Meridian Ave, 5th Floor, Jazz Festival Miami Beach FL 33139 01/25/2024 2 Tickets to The Bass Ball $7,500 Silvia Karman 2100 Collins Ave, Miami Cubina Beach FL 33139 02/11/2024 3- Night Stay at Cozumel $725.14 Lucy Delgado Cantera Costera Sur KM 1.7, CP77600 San Miguel de Hotel & Cozumel 0.R 02/22/2024 2 VIP Tickets to SOBE exceeds $100 Lee Brian Schrager 5802 Benjamin Center Dr. Wine & Food Festival Ste 110, Tamp a FL 33634 □CHECK HERE IF CONTINUED ON SEPARATE SHEET PA R T B -- R E C EI P T PR O V ID E D B Y P E RS O N M A K ING TH E G IFT 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 PAR T C - O ATH 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 I(·sting of all gifts required to be reported by Section 112.3148, ' tor«a sat.\ My , 1--a SIG srArE or FoRIDA· T} -IQ couNTY or A±aS MOX, syomn to (or affirmed) and subscribed before me by means of J::::t•qil gresence or online notarization, this --"-~-=""'-~---day of..:::,,,'-=""-"""...:.----· 2~--~N-'=1----- (Print, Type, or Stamp Commissioned Name Personally Known _k OR Produced Id Type of Identification Produced l i ALI CE 8. g 0MM ISSIOI "72 56 0 EXPIRES: JUI !026 nded through 1st Insurance PA R T D - FILI N G INS TR UCTIO NS 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 FOR M 9 - EFF. 1/2016 (R efer to Rule 34-7.010(1)(9), F.A.C.) (See reverse side for instructions) @