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Home My WebLink About2018-08-03 Form 700 - HarnikSTATEMENT OF ECONOMIC INTERESTS RECEIVED CITY CLERIC'S OFFICE COVER PAGE PALM DESERT, C4 Please type or print in ink. NAME of FILER (LAST) (FIRST) IQ Harnik Jan C 1. Office, Agency, or Court Agency Name (too not use acronyms) City of Palm Desert Division, Board, Department, District, if applicable Your Position City Council Councilmember ► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: 2. Jurisdiction Of Office (Check at least one box) ❑ State ❑ Multi -County ❑x City of Palm Desert 3. Type of Statement (Check at least one box) ❑ Annual: The period covered is January 1, 2017, through December 31, 2017. -or- The period covered is December 31, 2017. ❑ Assuming Office: Dale assumed Position .. ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other . ❑ Leaving Office: Date Left ---J---J (Check one) through O The pem;c covered is January 1, 2017, through the date of -or- leaving office. O The period covered is I I through the date of leaving office. ❑x Candidate: Date of Election Nov_ 6, 2018 and office snught, if different than Pad 1: 4. Schedule Summary (must complete) ► Total number of pages including this cover page: Schedules attached ❑x Schedule A-1 -investments - schedule attached ❑ Schedule A-2 - investments - schedule attached ❑x Schedule B - Real Property - schedule attached -or. Ll None - No reportable interests on any schedule ❑x Schedule C - Income, Loans, & Business Positions - schedule attached ❑ Schedule D - Income - Gifts - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached 5. Verification MAILING ADDRESS STREET CITY STATE Z P COPE (Business or Agency Addmss Remniended - Public Doctmnt) Indian Wells CA 92210 ( I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of Califomia that the foregoing is true and correct. _ Date Signed August 1, 2018 - (—rdh. day, yWri Signature FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov 0 SCHEDULE A-1 0 iCALIFORNIA Investments FAM POLITICAL PRACTICES COMMISSION Stocks, Bonds, and Other Interests Name (Ownership Interest is Less Than 10%) Jan C Harnik Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY Lowe's _ GENERAL DESCRIPTION OF THIS BUSINESS Home Improvement FAIR MARKET VALUE ❑ $2.000 - $10.000 X❑ $10,001 - $100,000 ❑ $100,001 - $1,000.000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑X Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule q IF APPLICABLE, LIST DATE: If / 17 1 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Exxon GENERAL DESCRIPTION OF THIS BUSINESS Oil FAIR MARKET VALUE ❑ $2.000 - $10.000 X❑ S10,0c.1 - $100,000 $100,001 - $1,000,000 ❑ Over $1,000.000 NATURE OF INVESTMENT ❑X Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: / 17 1 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Apple, Inc GENERAL DESCRIPTION OF THIS BUSINESS Consumer Electronics FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10.001 - $100,000 x❑ $100,001 - $1,000.000 ❑ Over $1,000,000 NATURE OF INVESTMENT XO stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: I-1 171 17 ACQUIRED DISPOSED Comments: 11- NAME OF BUSINESS ENTITY AT&T GENERAL DESCRIPTION OF THIS BUSINESS Communications FAIR MARKET VALUE ❑ $2,000 - $10,000 K❑ $10.001 - $100.000 ❑ $100,001 - $1,000,000 ❑ Over $1.000,000 NATURE OF INVESTMENT ❑X Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: —1�1 17 _ 1 1 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Pfizer GENERAL DESCRIPTION OF THIS BUSINESS Pharmaceuticals FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑X $10,001 - $100,000 ❑ $100 0o1 - $1,000 Goo ❑ Over $1,000,000 NATURE OF INVESTMENT X Stock ❑ Other (Describe) Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Repot on Schedule C) IF APPLICABLE, LIST DATE: 17 �� 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY First Foundation Bank GENERAL DESCRIPTION OF THIS BUSINESS Bank FAIR MARKET VALUE XZ $2.000 • $10,000 ❑ $10001 - $100.000 ❑ $100.001 - $1,000 000 ❑ Over $1,000 000 NATURE OF INVESTMENT X❑ Stock ❑ Other (Describe) ❑ Partnersh p O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C] IF APPLICABLE, LIST DATE: 1../ 17 —t 1 17 ACQUIRED DISPOSED FPPC Form 700 (2017/2018) Sch. A-1 FPPC Advice Email: advice@fppc.ca.gov FPPC Tall -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10%) Do not attach brokerage or financial statements. ► NAME OF BUSINESS ENTITY North Sphere Associates LLC GENERAL DESCRIPTION OF THIS BUSINESS Commercial Real Estate FAIR MARKET VALUE ❑ $2.000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,00, - $1,000,000 ❑ over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑X Partnership Income Received of $0 - $499 O Income Received of $500 or More (Report an Schedule C) IF APPLICABLE, LIST DATE: I / 17 I_ 117 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2.000 - $10,000 ❑ $10,00, - $100,000 ❑ $100.001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other {Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C IF APPLICABLE, LIST DATE: /1. 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $io,001 - $10o,o0o ❑ $10o,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe' ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedwe C) IF APPLICABLE, LIST DATE: 1. 1. 17 —J—� 17 ACQUIRED DISPOSED Comments: Name Jan C Harnik ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,00o ❑ $10,001 - $100,000 ❑ $100-001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Descrbe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE � / 17 �/_J 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENE RAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100.000 ❑ $100,D01 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership Q Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: �Jit 17 �_� 17 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF THIS BUSINESS FAIR MARKET VALUE ❑ $2.000 - $10.000 ❑ $10,001- $100,000 r $100.001 $1,000,000 ❑ Over $1.000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) t� Partnership O Income Received of $0 - $499 O Income Received of S500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: � / 17 —JT! 17 ACQUIRED DISPOSED FPPC Form 700 (2027/2018) Sch. A-1 FPPC Advice Email: advice@)fppc.ca.gov FPPC Toll -Free Helpline: 866/Z75-3772 www.fppc.ca.gov n n SCHEDULE B Interests in Real Property (Including Rental Income) ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY Indian Wells, CA 92210 FAIR MARKET VALUE ❑ $2,000 - $10 000 ❑ $10,001 - $100,00o ❑ $100,0o1 - $1,OOo,o00 XJ Over $1 000,000 NATURE OF INTEREST ❑X OwnershiplDeed of Trust ❑ Leasehold .. Yrs remaining IF APPLICABLE, LIST DATE: ____l__/a7 --J—J17 ACQUIRED DISPOSED ❑ Easement ❑ — Othar IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 Ej $500 - $1.000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,o00 ❑X OVER $100.000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. ❑ None Bernheimer PC; Grand Luxury Properties Inc; Donald Protoqual, Saltarelli Law Corporation, Hughes & Hughes Name Jan C Hamik ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY ... _ . Palm Desert, CA 92260 FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10.001 - $100,000 ❑X $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INTEREST ❑X Ownership/Deed of Trust IF APPLICABLE, LIST DATE: 1. 17 �/ 117 ACQUIRED DISPOSED ❑ Easement ❑ Leasehold -. _ ❑ Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 $499 ❑ $500 - $1,000 ❑ $1,001 - $10.000 ❑X $10 001 - $100,000 ❑ OVER $100.000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. None George Cunha * You are not required to report loans from commercial lending institutions made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER* ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 ❑ Guarantor, if applicable Comments: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (MonthsNearsl % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10.000 ❑ $10.001 - $100,000 ❑ OVER $100.000 ❑ Guarantor, if applicable FPPC Form 700 (2017/2018) Sch. B FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov 0 0 SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Roemer & Hamik ADDRESS (Business Address Acceptable) Indian Wells, CA 92210 BUSINESS ACTIVITY, IF ANY, OF SOURCE Law Firm YOUR BUSINESS POSITION none - Spouse's Company GROSS INCOME RECEIVED ❑ No Income - Business Position Only ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,00, - $100,000 Q OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary Q Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of (Real property, car. boat, etc.) ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source or S10,0W or more (Describa) ❑ Other NAME OF SOURCE OF INCOME Brian S. Harnik, Inc. ADDRESS (Business Address Acceptable) Indian Wells, CA 92210 BUSINESS ACTIVITY, IF ANY, OF SOURCE Professional Corporation YOUR BUSINESS POSITION Managing Service GROSS INCOME RECEIVED ❑ No Income - Business Position Only ❑ $500 - $1,000 ❑ $1,001 - $10,000 0 $10.001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED 0 Salary ❑ Spouse's or registered domestic partner's income (Far self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2. ) ❑ Sale of (Real property. car boat, etc,: ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of S10,000 or more Othe (Des -be) (Describe) * You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or Credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - 570,000 ❑ $10,001 - $100.000 ❑ OVER $100,000 Comments: - N rEREST RATE TERM (Months/Years) % ❑ None SECURITY FOR LOAN L] None ❑ Personai residence 0 Real Property ❑ Guarantor ❑ Other Straet address Ciry (Describe) FPPC Form 700 (2017/2018) Sch. C FPPC Advice Email: adviceit?fppc-ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov