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Home My WebLink About2014-10-18 Form 460 - HarnikRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. i CIT Y PAL Statement covers period Date of election if applicable: from 10/01/2014 (Month, Day, Yea2014 0 through 10/18/2014 1 11/04/2014 Date Stamp EDEIYED LERK'S OFFICE I DESERT. CA 20 PH 3:01 COVER PAGE Page I of -.S? _ For Official Use Only 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure E&+-Preelection Statement ❑ Quarterly Statement O State Candidate Election Committee Committee I { Semi-annual Statement ❑ Special Odd -Year Report p Recall Q Controlled ❑ Termination Statement ❑ Supplemental Preelection (Also Complete Part5) Q Sponsored Also file a Form 410 Termination ( ) Statement -Attach Form 495 ❑ General Purpose Committee (Also Complete Part 6) ❑ Amendment (Explain below) p Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER 1322067 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Re-elect Jan Hamik Palm Desert City Council 2014 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Palm Desert, CA 92260 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX Same CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Treasurer(s) NAME OF TREASURER Dr. William Kroonen MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Palm Desert, CA 92260 ( NAME OF ASSISTANT TREASURER, IF ANY Elizabeth Lopez MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Indio, CA 92203 ( OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification { have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjuryunderthe laws of the State of California that the foregoing is true Responsible Officer of Sponsor Executed on By Dale Signature of Controlling Officeholder, Candidate. State Measure Proponent Executed on By Date Signature ofContrdlfngOfficeholder, Candidate. State Measure Proponent FPPC Form 460 (January105) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California Recipient Committee Type or print in ink. COVER PAGE - PART 2 Campaign Statement CALIFORNIA, .1 Cover Page —Part 2 FORM 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jan Hamik OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council / City of Palm Desert RESIDENTIAL(BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Palm Desert, CA 92260 Related Committees Not Included in this Statement: List any 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 NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO AUURF-55 (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEEADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Page A of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION ElSUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 10/01/2014 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER J Re-elect Jan Hamik Palm Desert City Council 2014 Contributions Received ColumnA Column TOTALTHIS PERIOD (FROMATTACHED SCHEDULES) CALENDAR YEAR TOTALTODATE 1. Monetary Contributions ... Schedule A, Line 3 $ 1,965.00 $ 29,309.00 2. Loans Received...................................................... Schedule A Line 3 00.00 11,798.08 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ 1,965.00 $ 41,107.08 4. Nonmonetary Contributions .................................... Schedule C, Line 3 00.00 1,090.00 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 1,965.00 $ 42,197.08 Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 8,612.50 $ 30,795.51 7. Loans Made............................................................. Schedule H Una 3 00.00 00.00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 8,612.50 $ 39,408.01 9. Accrued Expenses (Unpaid Bills) ............................... schedule F Line 3 00.00 00.00 10. Nonmonetary Adjustment .......................................... schedule C, Line 3 00.00 00.00 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8+9+10 $ 8,612.50 $ 39,408.01 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 39,091.17 13. Cash Receipts ................................................... Column A, Line 3 above 1,965.00 14. Miscellaneous Increases to Cash ........................... Schedule /, Line 4 00.00 15. Cash Payments .................................................. Column A, Line 8 above 8,612.50 16. ENUNG CASH BALANCE .......... Add lines 12 + 13 + 14, then subtract Line 15 $ 32,443.67 If this is a termination statement, Line 16 must be zero. 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 + Line 9 in Column B above $ MCI 11,798.08 To 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). SUMMARY PAGE 10/18/2014 Page of I.D. NUMBER 1322067 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 711 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (It Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) -_J $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A Type or print in Ink. SCHEDULE A ""'VY"" "'a Yei V'""'Cu One ryContributionsReceivedto whole dollars. Statement covers period CALIFORNIA from 10/01/2014 FORM• SEE through 10/18/2014 INSTRUCTIONS ON REVERSE Page of NAME OF FILER Re-elect Jan Hamik Palm Desert City Council 2014 I.D. NUMBER 1322067 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.D.NUMBER) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF•EMPLOYED.ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Michael A. Peroni ®IND ❑COM Consultant 10/8/2014 ❑ PTY ❑SCC Mark Bragg RIND ❑COM Investor 10/9/2014 ❑ PTY ❑SCC 10/11/14 Frank Harrison ❑OTH General Air Conditioning ❑PTY & Heating [-]SCC 10/11/14 Joe Pradetto ❑OTH County of Riverside 100.00 100.00 ❑ PTY []SCC John Wessman RIND President 10/11/14 ❑ PTY ❑SCC SUBTOTAL $ 1,300 00 5chedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.)........................................................................................................ $ 2. Amount received this period — unitemized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ....................... TOTAL $ 1,720.00 245.00 1,965.00 *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received Type or print In ink. Amounts may be rounded to whole dollars. Re-elect Jan Hamik Palm Desert City Council 2014 1 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER RECEIVED OF COMMITTEE, ALSO ENTER I.D. NUMBER) OCCUPATION AND EMPLOYER CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Bud Johnson 01ND Owner 10/11/2014 ❑ PTY ❑SCC Betty Baxter 01ND Self Employed 10/11/14 ❑OTH ❑ PTY ❑ SCC Sandra Hardin ®IND Owner 10/11/14 ❑OTH ❑ PTY []SCC Brian Ward 01ND Retired 10/11/14 ❑OTH ❑ PTY ❑ SCC ❑ IND [3Com ❑ OTH ❑ PTY ❑ SCC SUBTOTALS '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 Statement covers period from 10/01 /2014 through 10/18/2014 SCHEDULE A (CONT.) Page 5 of 1322067 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) 120.00 1 120.00 100.00 1 100.00 100.00 1 250.00 100.00 100.00 420.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule B — Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Re-elect Jan Harnik Palm Desert City Council 2014 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Brian S. Harnik t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Type or print in ink. Amounts may be rounded Statement covers period to whole dollars. 10/01/2014 from _._ _ _— _ through _ 10/18/2014 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER Self Roemer & Harnik LLP BALANCE BEGINNING RECEIVED THIS AMOUNTPAID OR UU IS IANUING BALANCEAT THIS PERIOD PERIOD FORGIVEN THIS PERIOD' CLOSE OF THIS _ PERIOD _ ❑ PAID $ _ S 11,798.08 ❑ FORGIVEN 11, 798.08 00.00 SCHEDULEB-PART1 Page of I.D. NUMBER 1322067 INTEREST ORIGINAL CUMULATIVE PAID THIS AMOUNT OF CONTRIBUTIONS PERIOD LOAN TO DATE CALENDAR YEAR % S 18,000. S RATE PER ELECTION— S $— -- $ — $ 10/01/10 DATE DUE $ _ DATEINCURRFD ❑ PAID _ CALENDAR YEAR $— S_ _ $ _ $ ❑ FORGIVEN RATE PER ELECTION"` $ Is SUBTOTALS $ 00.00 $ S ^DATE DUE DATE INCURRED ❑ PAID _ — _ _ -- CALENDAR YEAR $ $ - ti ❑ FORGIVEN RATE f PERELECTION" OATS DUE S DATE INCURRED I S $ 11,798.08 S Schedule B Summary 1. Loans received this period................................................................................................................. $ 00.00 (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period......................................................................................................... $ 00.00 (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 $ 00.00 Enter the net here and on the Summary Page, Column A, Line 2. (May be anegativenumber) 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. (Enter (e) on Schedule E. Line 3) tContributor 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Re-elect Jan Hamik Palm Desert City Council 2014 Type or print in ink. Amounts may be rounded to whole dollars. SCHEDULE Statement covers period - � � ' from 10/01/2014 • - through 10/18/2014 Page of 3— I.D. NUMBER1322067 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalia/misc. CrJS campaign consultants MBR MT member communications RAD radio airtime and production costs CTB contribution (explain nonmonetary)' OFC meetings and appearances office expenses RFD returned contributions CVC civic donations FFND 1L candidate filing/ballot fees PET petition circulating SAL campaign workers' salaries TEL t.v. or cable airtime and production costs fundraising events PHO POL phone banks polling and survey research TRC candidate travel, lodging, and meals RZ independent expenditure supporting/opposing others (explain)' LEG legal defense POS PRO postage, delivery and messenger services TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor LIT campaign literature and mailings PRT professional services (legal, accounting) print ads VOT voter registration WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Palm Desert Area Chamber of Commerce 72-559 Highway 111 Golf Cart Parade Entry Fee Palm Desert, CA 92260 110.00 Buzz Factory 1801 East Tahquitz Canyon Way, Suite 101 Palm Springs, CA 92262 POS 4,661.30 Buzz Factory 1801 East Tahquitz Canyon Way, Suite 101 Palm Springs, CA 92262 POS 958.20 ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 5,729.50 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................... $ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 8,612.50 00.00 00.00 8,612.50 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Re-elect Jan Hamik Palm Desert City Council 2014 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from— 10/01/2014 through 10/18/2014 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, CIVP CNS campaign paraphernalia/misc. campaign consultants MBR member communications RAID contribution (explain nonmonetary)' MTG OFC meetings and appearances office expenses CVC civic donations candidate filing/ballot fees PET petition circulating SAL TEL.RL FND fundraising events PHO POL phone banks polling and survey research TRC IND LEG independent expenditure supporting/opposing others (explain)' legal defense POS postage, delivery and messenger services TRS TSF LIT campaign literature and mailings PRO PRT professional services (legal, accounting) VOT print ads WEB NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Buzz Factory 1801 E. Tahquitz Canyon Way, Suite 101 Palm Springs, CA 92262 Buzz Factory 1801 E. Tahquitz Canyon Way, Suite 101 Palm Springs, CA 92262 Buzz Factory 1801 E. Tahquitz Canyon Way, Suite 101 Palm Springs, CA 92262 Family YMCA of the Desert 43-930 San Pablo Avenue Palm Desert, CA 92260 CODE OR PRT LIT POS SCHEDULE E (CONT.) Page of v I.D. NUMBER 1322067 describe the payment. radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (intemet, e-mail) DESCRIPTION OF PAYMENT Y Be Fit Event - Booth Rental Fee AMOUNT PAID 610.00 1,873.00 150.00 250.00 Payments that are contributions or independent expenditures must also be summarized on Schedule D. 1 SUBTOTAL $ 2,883.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)