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Home My WebLink AboutForm 460 - Firefighters' Association PAC (2018-12-31)Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE WCOVER PAGE [E VaILIa In Statement covers period Date of election if applie JAN 1 5 f 7 7/11/2018 (Month, Day, Year) 2019lFmeoOnly from through 12/31/2018 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Cwpkto Pad 8) 0 Sponsored STATE (Abe Corrpktt Ped 8) ® General Purpose Committee * Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (A1soCWWA!faPort J 3, Committee Information I.D. NUMBER 891308 ;OMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) San Rafael Firefighters Political Awareness Committee STREET ADDRESS (NO PO BOX) 999 5th Ave Suite 350 CITY STATE ZIP CODE AREA CODEIPHONE San Rafael Ca 94901 415-726-4394 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR PO BOX PO BOX 2519 CITY STATE ZIP CODE AREACODE/PHONE SAN RAFAEL CA 94912 415-726-4394 OPTIONAL: FAX/E-MAIL ADDRESS LCITY CLERK'S CFFIPE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement IR Semi-annual Statement ❑ Speclal Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER ANDREW ROGERSON MAILING ADDRESS 1532 MATHIAS PL CITY STATE ZIP CODE AREA CODE/PHONE BOHNERT PARK CA 94928 415-726-4394 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the Information contain herein and In the attache dules Is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing Is an correct. Executed on ` BY %✓� 7-7,b t Slgnatur rAsslstant esurer Executed on BY 111 Vote Slgne . oiling Officeholder. Candidate, to MeasurePr ant or Responsible Officer of Sponsor Executed on BY 11 1 Date Signature of Controlling Officeholder,G dldete, State M Proponent Executed on BY Date Signature or Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded to whole dollars. Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER SAN RAFAEL FIREFIGHTERS POLITICAL AWARENESS COMMITTEE Contributions Received 1. Monetary Contributions................................................... Schedule A, Linea 2, Loans Received................................................................ schedule B,Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1+2 4. Nonmonetary Contributions ............................................ schedule c, Line 3 5, TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3+4 Expenditures Made 6. Payments Made................................................................ schedule E, Line 7. Loans Made....................................................................... schedule H, Line 8. SUBTOTAL CASH PAYMENTS,, ........................................ Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F, Line 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, Line 8 above 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero. Column A TOTAL THIS PERIOD FROM ATTACHED SCHEDULES) 0 I V $ 0 0 $ 0 $ 4,727.54 0 $ 4,727.54 0 0 Statement covers period from 7/112018 through 12/31/2018 Column B CALENDAR YEAR TOTAL TO DATE $ 0 0 $ 0 0 $ C $ 5,227.54 0 $ 5,227.54 0 0 $ 4,727.54 $ 5,227.54 $ 85,929.33 0 8.33 17. LOAN GUARANTEES RECEIVED ................................ schedule e, Part2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 91n Column B above $ 4,727.54 81,210.12 2 u I 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 Page 2 of 7 I.D. NUMBER 891308 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21, Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (If Sublect to Voluntary Expandlture Lim It) Date of Election Total to Date (mm/dd/yy) $ •Amounts In this section may be different from amounts reported In Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ce.gov (866/275-3772) www.fppc.ca.gov Schedule A Monetary Contributions Received Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER SAN RAFEAL FIREFIGHTERS POLITICAL AWARENESS COMMITTEE DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR [FAN INDIVIDUAL, ENTER RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ Schedule 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 $ from _ through SCHEDULE A t covers period 7/1/2018 12/31/20183 7 Pane -of - AMOUNT RECEIVED THIS PERIOD Q LD. NUMBER 891308 CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE (JAN. 1 -DEC.: (IF REQUIRED) .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 D Summary of Expenditures Amounts may be rounded Supporting/Opposing Other to whole dollars. Candidates, Measures and Committees NAME OF FILER SAN RAFEAL FIREFIGHTERS POLITICAL AWARENESS COMMITTEE DATEI MEASURE NUMBER OR LET ITTEE D JME OF CANDIDATE, OFFICE, AND URISTRICT, ORSDICTION, RISDICT ON, I TYPE OF PAYMENT I QUIRED)) ❑ Support ❑ Oppose rt ❑ Support ❑ Oppose ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent Expenditure from — through SUBTOTAL $ covers period 7/1 /2018 12/31/2018 page 4 of 7 AMOUNT THIS PERIOD I.D. NUMBER 891308 CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TO DATE (JAN. t -DEC. 31) (IF REQUIRED) Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)....................................................... $ 0 2. Unitemized contributions and independent expenditures made this period of under $100 ..................................................... $ 0 3, Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summa ryPa e.) ........,. TOTAL .. $ 0 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. SAN RAFAEL FIREFIGHTERS POLITICAL AWARENESS COMMITTEE SCHEDULE E Statement covers period CALIFORNIA 460 from 7/1/2018 FORM through 12/31/2018 page 5 of 7 I.D. NUMBER 891308 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAD radio alrtlme 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 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. ALSO ENTER I D. NUMBER) COSTCO 1900 SANTA ROSA AVE SANTA ROSA CA 95407 CPF PRINT AND DESIGEN 1780 CREEKSIDE OAKS DR SACRAMENTO CA 95833 CARDENAS NARKET 330 BELLAM BLVD SAN RAFAEL CA 94901 CODE OR DESCRIPTION OF PAYMENT MTG CMP MTG SUPPLIES FOR CITY COUNCIL RALLY CITY COUNCIL RALLY SIGNS FOOD FOR CITY COUNCIL RALLY AMOUNT PAID $158.07 $365.24 $1054.23 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1577.54 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals.)$ 4,727.54 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ 4,727.54 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded (Continuation Sheet) to whole dollars. Payments Made SEE INSTRUCTIONS ON REVERSE SAN RAFEAL FIREFIGHTERS POLITICAL AWARENESS COMMITTEE Statement covers period 7/1/2018 from 12/31/2018 through SCHEDULE E (CONT.) Page 6 of I.D. NUMBER 891308 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. A d ctl n costs CMP campaign paraphernalia/misc. MBR MTG member communications meetings and appearances RAD RFD radio airtime an pro. o returned contributions CNS CTB campaign consultants 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 IND fundraising events Independent expenditure supporting/opposing others (explain)' POL POS polling and survey research postage, delivery and messenger services TRS TSF staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT eamoalon literature and mallinas PRT print ads WEB Information technology costs (Internet, a -mall) NAMEANDADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID MESSING ADAM & JASMINE 980 9TH ST SACRAMENTO CA 95814 LEG LEGAL EXPENSES $375,00 MESSING ADAM &JASMINE 9809TH ST SACRAMENTO CA 95814 LEG LEGAL EXPENSES $2,100.00 SAN RAFAEL FIRE FOUNDATION 369 B 3RD ST SAN RAFAEL CA 94901 CVC FIRE FOUNDATION CARB FEED $675.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 3,150.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash SAN RAFEAL FIREFIGHTERS POLITICAL AWARENESS COMMITTEE Amounts may be rounded to whole dollars. DATE FULL NAME AND ADDRESS OF SOURCE RECEIVED (IF COMMITTEE,ALSO ENTER I.D. NUMBER) BANK OF AMERICA 1000 4TH ST SAN RAFAEL CA 94901 12/3112018 SCHEDUL Statement covers period CALIFORNIA I 7/1/2018 FORM from through 12/31/2018 Page 7 of 7 I.D. NUMBER 891308 AMOUNT OF DESCRIPTION OF RECEIPT INCREASE TO CASH INTREST EARNED $8.35 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 8.35 Schedule I Summary $ 8.35 1. Itemized increases to cash this period........................................................................................................................ 0 2. Unitemized increases to cash of under $100 this period.................................................................................................$ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) .................................... 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the 8,35 SummaryPage, Line 14.)............................................................................................................................. TOTAL $ FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/27S-3772) www.fppc.ca.gov