HomeMy WebLinkAboutForm 806 - City of San Rafael 2023Agency Report of:
Public Official Appointments
A Public Document
1. Agency Name
Agency Boards and
Commissions
City of San Rafael
Appt Date and
Length of Term
Per MeetinglAnnual Salary/Stipend
For O7UseOnly
Division, Department, or Region (If Applicable)
San Rafael City Council
►Per Meeting: $
100.00
Designated Agency Contact (Name, Title)
Jim Schutz, City Manager
► 12 / 05 / 22
Page 1 of 1
Date Posted:
12/05/2022
(Last, First)
Area CodelPhone Number
E-mail
415-485-3070
city.manager@cityofsanrafae1.org
(Month, Day, Year)
2. Appointments
Agency Boards and
Commissions
Name of Appointed Person
Appt Date and
Length of Term
Per MeetinglAnnual Salary/Stipend
San Rafael Sanitation
Kate Colin
►Per Meeting: $
100.00
District
►Name
► 12 / 05 / 22
(Last, First)
Appf Data
1 Estimated Annual:
Rachel Kertz
1 year
}
El $o-$1,000
El $2,001-$3,000
Alternate, if any
(Last, First)
9$1,001-$2,000
❑
Other
San Rafael Sanitation
Maribeth Bushey
1205 22
/ /
/ Per Meeting: $
100.00
District
►Name
►
Estimated Annual:
Rachel Kertz
1 year
► y
❑ $0-$1,000
❑ $2,001-$3,000
Alternate, if any
Length of Term
E]$1,001-$2.000
❑
Other
►Name
► l l
► Per Meeting: $
(Last, Firsr,
Appt Date
1 Estimated Annual:
Alternate, if any
/
El $0-$1,000
El $2.00143,000
Length of Term
(Last, First)
El $1,00142,000
❑
Other
Warne
Alternate, if any
Per Meeting: $
Appt Data
/ Estimated Annual:
/ ❑$0-$1,000 ❑$2,001-$3,000
Length of Term
❑$1,001-$2,000 ❑
Other
3. Verification
I haAlq.aftr,
Lin rsran Rego [ran 1870 -have verified that the appointment and information identified above is true to the best of my information and belief.
Jim Schutz City Manager 12/5/2022
of Agency Head sglree Print Name Title (Month, Day, Year)
Comment:
FPPC Form 806 (1/18)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)
Agency Report of:
Public Official Appointments
Background
This form is used to report additional compensation that officials
receive when appointing themselves to positions on committees,
boards, or commissions of another public agency or to a
committee or position of the agency of which the public official is
a member.
This form is required pursuant to FPPC Regulation 18702.5.
Each agency must post on its website a single Form 806 which
lists all the paid appointed positions to which an official will vote
to appoint themselves. When there is a change in compensation
or a new appointment, the Form 806 is updated to reflect the
change. The form must be updated promptly as changes occur.
Instructions
This form must be posted prior to a vote (or consent item) to
appoint a governing board member if the appointee will participate
in the decision and the appointment results in additional
compensation to the appointee.
FPPC Regulation 18702.5 provides that as long as the public
is informed prior to a vote, an official may vote to hold another
position even when the vote results in additional compensation.
Part 1. Agency Identification
Identify the agency name and information on who should be
contacted for information.
Part 2. Appointments
Identify the name of the other agency, board or commission. List
the name of the official, and an alternate, if any.
List the appointment date and the length of term the agency
official will serve. Disclose the stipend provided per meeting and
the estimated annual payment. The annual salary is an estimate
as it will likely vary depending upon the number of meetings. It
is not necessary to revise the estimate at the end of the calendar
year.
Part 3. Verification
The agency head or his/her designee must sign the verification.
Frequently Asked Questions (FAQs)
When does an agency need to complete the Form 806?
A Form 806 is required when an agency's board members
vote to appoint a board member to serve on another
governmental agency or position of the agency of which the
official is a member and will receive additional compensation.
2. The city council votes to serve as the city's housing authority,
a separate entity. Will the Form 806 be required?
If the council members receive additional compensation for
serving on the housing authority, the Form 806 is required.
A Public Document
3. Are appointments made by a governing board to appoint
one of its members to serve as an officer of that board for
additional pay (e.g., mayor) required to be disclosed on Form
806?
No. FPPC Regulation 18702.5(b)(6) exempts from this
requirement decisions to fill a position on the body of which
the official is a member (such as a councilmember being
appointed as mayor) despite an increase in compensation.
4. In determining the income, must the agency include mileage
reimbursements, travel payments, health benefits, and other
compensation?
No. FPPC Regulation 18702.5 requires only the amount of
the stipend or salary to be reported.
5. Which agency must post the Form 806?
The agency that is voting to appoint a public official must post
the Form 806 on its website. The agency that the official will
serve as a member is not required to post the Form 806. The
form is not sent to the FPPC.
6. When must the Form 806 be updated?
The Form 806 should be amended promptly upon any of
the following circumstances: (1) the number of scheduled
meetings is changed, (2) there is a change in the
compensation paid to the members, (3) there is a change in
membership on the board or commission, or (4) there is a
new appointment to a new agency.
7. If officials choose to recuse themselves from the decision
and leave the room when a vote is taken to make an
appointment, must the Form 806 be completed?
No. The Form 806 is only required to identify those officials
that will vote on an appointment in which the official will also
receive additional compensation.
Privacy Information Notice
Information requested by the FPPC is used to administer and
enforce the Political Reform Act. Failure to provide information
may be a violation subject to penalties. All reports are public
records available for inspection and reproduction. Direct
questions to FPPC's General Counsel, Fair Political Practices
Commission, 1102 Q Street, Suite 3000, Sacramento, CA
95811.
FPPC Form 806 (1/18)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)