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HomeMy WebLinkAbout2016-12-31 Form 460 - NestandeRecipient Committee COVER PAGE Campaign Statement ERK'S OFFICE stamp Cover Page CIR/!LC DESERT CA SEE INSTRUCTIONS ON REVERSE Statement covers period from 10/23/16 through 12/31/16 1. Type of Recipient Committee: All Committees -- Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 Stale Candidate Election Committee Committee 0 Recall 0 Controlled (MwmFWrs) 0 Sponsored (%ho C.mpkra Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee fAmC-PWsPart 1) 3. Committee Information II.D. NUMBER 138756E COMMITTEE NAME JOR CANDIDATE'S NAME IF NO COMMITTEE) Gina Nestande for City Council, 2016 STREET ADDRESS (NO P.O. BOX) 74478 STATE ZIP CODE AREACOOEIPHONE Palm Desert Ca 92260 760- ADDRESS JIF DIFFERENT) NO. AND STREET OR RO. BOX CITY STATE ZIP CODE AREACOOEfPHONE OPTIONAL: FAXIE-MAILADDRESS gnestande@aol.com 4. Verification I have used all reasonable diligence In preparing and reviewing this statement and to the best of my certify under penalty of perjury under the laws of the State of California that the foregoing Is true and Executed on r r Z J —, 7 By 1 -,Date 5 17 Executed on Date By signature of coot Date of election if ap�l� -1 (f ; [� Page �� of (Month, Day, Ye For Official Use Only 1118/16 2. Type of Statement: ❑ Preelection Statement 0 Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ 'Germination Statement (Also file a Forth 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Joel Crouch MAILING ADDRESS 73828 STATE ZIP CODE AREA CODEWHONE Palm Desert Ca 92260 760- OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL. FAX I E-MAIL ADDRESS the information contained herein and in the attached schedules is true and complete. I OF or Executed on ByDate Signature of Controling OfficetxWer. Candidate. State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, Slate Measure Proponent FPPC Form 460 {Jan/2016) FPPC Advice: advice@)fppc.ca.gov (866/275-3772) Recipient Committee Campaign Statement Cover Page -- Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Gina Nestande for City Council, 2016 OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Palm Desert City Council RESIDENTIALIBU5INESS ADDRESS (NO. AND STREET) CITY STATE ZIP Palm Desert Ca 92260 Related Committees Not Included in this Statement: Llstany committees not Included In this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO STREET CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D NUMBER NAME OF TREASURER CONTROLLED COMMITTEE7 [I YES [I NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 Page 2 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE of _t_L BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER. CANDIDATE, OR PROPONENT 7. Primarily Formed Candidate/Officeholder Committee Listnames of officeholder(s) or candldate(s) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets If necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-37721 www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE to whole dollars. Statement covers period a Summary Page 10-23-16 OFF m from SEE INSTRUCTIONS ON REVERSE through 12-31-16 Page 3 off NAME OF FILER I.D. NUMBER Gina Nestande for City Council, 2016 1387569 Contributions Received 1. Monetary Contributions ................................................... schedule A, Line 3 2. Loans Received................................................................ schedule B, true 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 4. Nonmonetary Contributions ............................................ schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Unes 3 + 4 Expenditures Made 6. Payments Made................................................................ schedule E. Line 4 7. Loans Made....................................................................... schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS .......................................... Add Was 6 + 7 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 10. Nonmonetary Adjustment......................................................... schedule C, Line 3 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page. Line 16 13. Cash Receipts........................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash .................................. schedule 1 Line 4 15. Cash Payments......................................................... Column A, Una 8 above 16. SWING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 trthis is a termination statement, Line 16 must be zero. Column A Column B TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TDTALTO DATE 5699.00 37,782.00 $ $ 22,000.00 32,000.00 27,699.00 69,782.00 $ $ 100.00 3100.00 $ 27,799.00 $ 72,882.00 $ 38,706.00 0.00 $ 38,706.00 0.00 0.00 $ 38,706.00 $ 11,164.00 27„699.00 0.00 38,706.00 $ 157.00 17. LOAN GUARANTEES RECEIVED ................................ Schedule B. Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see Instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Una 9 in Column B above $ $28,500.00 g 71,940.00 0.00 $ 0.00 0.00 $ 71,940.00 Ta calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts In Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6130 711 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (K Subject to Voluntary Eapendklune Limes) Date of Election Total to Date (mmlddlyy) `Amounts In this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A. WING 0 """"'s• Monetary Contributions Received NO Statement covers period 10/23/16 from • � through 12/31/16 Page y of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Gina Nestande for City Council, 2016 1387569 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.O. NUMBER) CODE * OCCUPATION AND EMPLOYER IIF SELF-EMPLOYED, ENTER NAME RECEIVED THIS PERIOD CALENDAR YEAR (JAN. 1 - DEC. 31) TO DATE (IF REQUIRED) OF BUSINESS) Intemational Brotherhood of Electrical Workers ❑ IND if N U r-K imc Pa h e [$ 10/26/16 1405 Spruce St # G ❑ COM 0OTH 9 s �'� A $250.00 Riverside, Ca 92507 PTY ❑ SCC Harold Matner 0IND ❑ COM CEO/Chairman 11/3116 181 ❑ scC Martin Lax 0 IND ❑COM Attorney 11/3116 41995 ❑ scc Shannon Moraga 0IND Owner 11/4/16 78- ❑ scc Kathy Deeb 0IND Retired 1114/16 4 ❑ PTY ❑ scc SUBTOTAL $ 3199.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. q cl, OI) (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 3. Total monetary contributions received this period. Z O� (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PITY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca,gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) monetary VontriautionS KecOMU to wnole dollars. Statement covers period from 10-23-16 .. 1 through 12-31-16 Page of NAME OF FILER I.D. NUMBER Gina Nestande for City Council, 2016 1387569 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Gina Nestande ® IND Realtor 11-14-16 ❑ coM ❑ OTH Realty Executives $22,000 $32,000 ❑ PTY ❑ SCC RD Hubbard Ia IND RD Hubbard Enterprises 12-8-16 ❑ OTH ❑ PTY ❑ SCC Cole Burr 01ND Cole Burr 12-8-16 Burr-Tec Waste Industries ❑ coM President Burr- Tec $1500.00 ❑ PTv ❑ scC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 24,500 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g.. business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca,gov (866/275-3772) www.fppc.ca.gov Arneunts mar he rnunrlerl SCHEDULE 8 - PART 1 5chequle t3 —Part '! -- - -, -- to whole dollars. Statement covers period Loans Received 10-23-16 e - 011 I . ' - from , 12-31-16 7Page__(Q_ SEE INSTRUCTIONS ON REVERSE through of NAME OF FILER I.D. NUMBER Gina Nestande for City Council, 2016 1387569 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER to) OUTSTANDING IN AMOUNT IN AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER (IF COMMnTEE, ALSO ENTER I.D. NUMBER} OF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Gina Nestande Realtor ❑ PAID CALENDAR YEAR f RATE s $32,000.00 ❑ FORGIVEN PER ELECTION 510,000.00 $22,000.00 t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ DATE INCURRED 532,000.00 DATE DUE ❑ PAID CALENDAR YEAR s S % $ 5 ❑ FORGIVEN RATE PER ELECTION" t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC S S S s DATE INCURRED S DATE DUE ❑ PAID CALENDAR YEAR $ ❑ FORGIVEN RATE PER ELECTION" t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC i S $ $ DATE INCURRED S DATE DUE SUBTOTALS $ $ $ $ Schedule B Summary 1. Loans received this period ................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ 3.500 On (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.).............................................................NET $ _. JR'snn nn Enter the net here and on the Summary Page, Column A, Line 2. (May be anepalivenumber) 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. (Enter (a) on Schedule E, Line 9) Montributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY— Political Party SCC -- Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275.3772) www.fppc.ca.gov Schedule C Amounts may be rounded .....,IN 1 A ..- SCHEDULE C Nonmonetary Contributions Received Statement covers period . r , from 10/23/16 r - SEE INSTRUCTIONS ON REVERSE through 12/31 /16 page of —c- i NAME OF FILER I.D NUMBER 1387569 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED. ENTER GOODS DR SERVICES VALUE CALENDAR YEAR TO DATE (IF REQUIRED) NAME OF BUSINESS) (JAN 1 - DEC 31) Joel Crouch Ia IND Retired IND 10/24/16 ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.).....................................................................................................................$ 100.00 2. Amount received this period — unitemized nonmonetary contributions of less than $100..................................$ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.).....................TOTAL $ 100.00 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made Y SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars' Statement covers period SCHEDULE E e - • 1 from 1 a123116 • - 12/31/16 through Page of NAME OF FILER I.D. NUMBER 1387569 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalialm:sc. MBR member communications RAID radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonelary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meats FND fundraising events POL polling and survey research TRS stafflspouse travel, lodging, and meals IND independent expenditure supportinglopposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidatetsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Political Data Inc 1259 imperial Hwy POL $753.00 . Norwalk, Ca 90650 Andedot PO BOX 84314 OFC $19.00 Baton Rouge LA 70884 Adwerx 307 W Main St LIT 180.00 , Durham, NC 27701 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 952.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 3BI C )0 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 0. DD 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0, OD 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ . 30� 7c�o` 00 FPPC Form 460 (?an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E (CONT.) Amounts may be rounded (Continuation Sheet) to whole dollars. Statement covers period Payments Made from 10/23/16 • - !Page 12/31/16 r SEE INSTRUCTIONS ON REVERSE through of t NAME OF FILER ITNUMBER Gina Nestande for City Council, 2016 1387569 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL Lv. or cable airtime and production costs FIL candidate fiilinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS stafflspouse travel, lodging, and meals IND independent expenditure supportinglopposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMRiE6, ALSO F,NTER Lp, HUMBERJ CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Sign A Rama 41945 Boardwalk # L CMP $1086.00 Palm Desert, Ca 92260 Julie Kirk 74560 Remirez- Spirit of Dance 74475 Thomas Golf Carts PRO $175.00 Chris Henson Productions 77361 Camino Quintana PRO $200.00 La Quinta, Ca 92253 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS 1791.00 0 FPPC Form 460 IJFan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) ......... s... — Schedule E Amounts may be rounded (Continuation Sheet) to whole dollars. Payments Made SEE INSTRUCTIONS ON REVERSE Statement covers period from 10-23-16 through 12-31-16 SCHEDULE E (CONT.) Page _! v of it 1- "' ' — Gina Nestande for City Council, 2016 I.D. NUMBER 1387569 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign peraphemalialmisc. MBR member communications RAO radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundralsing events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)` POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, pL50 ENTER I.U. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Berg Print and Mail 522 Amigos Dr LIT $26,618.00 Redlands, Ca 92373 Voterlink 13348 Alpine Cove Dr CMP $1180.00 Alpine, UT 84004 Uribe Printing 2900 Adams St LIT $2719.00 Riverside, Ca 92504 US Postal Service 5172 Arlington Ave POS $2286.00 Riverside, Ca 92504 Rito Rios PO BOX 955 POS $600.00 La Ouinta, Ca 92247 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 33,403.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period from 10-23-16 through 12-31-16 SCHEDULE E (CONT.) Page I [ of `t 11387569 I.D. NUMBERIGina Nestande for City Council, 2016 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals 1ND independent expenditure supporting/opposing others (explain)` POS postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB Information technology costs (Internet. e-mail) NAME AND ADDRESS OF PAYEE (IF COMMnTEE, ALSO ENTER I.U. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID BPC Media Works 4290 Brockton Ave LIT $2500.00 Riverside, CA 92501 Constant Contact 1601 Trapelo Rd WEB $60.00 Walton, MA 02451 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $2560 FPPC Form 460 (?an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772)