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Home My WebLink AboutForm 460 - Randy Warren for City Council 2013 (2013-10-19)Recipient Committee Campaign Statement CoverPage (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from 9/22/2013 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Randy Warren for City Council 2013 STREET ADDRESS (NO P.O. BOX) 10/19/2013 SEE INSTRUCTIONS ON REVERSE through 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2; 3, and 4. Officeholder, Candidate Controlled Committee 0 Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee ZIP CODE AREA CODE/PHONE 0 Sponsored Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1359636 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Randy Warren for City Council 2013 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94903 MAILING ADDRESS (IF DIFFERENT) NO, AND STREET OR P.O. BOX PO Box 6285 CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94903 OPTIONAL: FAX i E-MAIL ADDRESS Date of election if applicable: Page. Of 8 (Month, Day, Year) R For Official Use Only Off' Ice o4: 111512013 y _;I # TiK. 2. Type of Statement: 0 Preelection Statement Quarterly Statement ❑ Semi-annual Statement 0Special Odd -Year Report ❑ Termination Statement F -I Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 Q Amendment (Explain below) Treasurer(s) NAME OF TREASURER Sue Ellen O'Brien MAILING ADDRESS PO Box 6285 CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94903 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX I E-MAIL ADDRESS A. Verification I 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 perjury under th laws of e State of California that the foregoing is true and corr1e;;q*4 Executed on By of Treas r Assistant Treasurer e of T, ea b, Assistant Treasurer I Da t*tgnz ,*re -�7 Executed on By Date S'tgr,*ure`6Cr_,,ntro1fing Offic;xrder,Car dilate, State Measure Proponent or Responsible Officer of Sponsor Executed on Date By Signature of ControffiN Officeholder, Candidate, State Measure Proponent Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE RANDY WARREN OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL, CITY OF SAN RAFAEL RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP SAN RAFAEL CA 94903 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 CONTROLLED COMMITTEE? YES F-1 NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? E YES NO COMMITTEE ADDRESS STREET ADDRESS NO P.O. BOX) CITY STATE ZIP CODE AREA CODEiPHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION F-1 SUPPORT Q 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 F-JOPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT F-JOPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD [:] SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE FPLC Form 464 January 05) FPPC Tall -Free Helpline. 866/ASIS-FPPC (866/275-3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER RANDY WARREN Type or print in ink. Amounts may be rounded to whole dollars. Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $37360 $ 7. Loans Made ............................................................. Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 3,360 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 3,360 $ 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 /, 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. 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 $ SUMMARY PAGE Statement covers periodCALIFORNIA Column A Contributions Received TOTALTHIS PERIOD FORM 77197 (FROM ATTACHED SCHEDULES) 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 71824 $ 2. Loans Received ...................................................... Schedule B, Line 3 10/19/2013 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 7,824 $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 999 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 8,823 $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $37360 $ 7. Loans Made ............................................................. Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 3,360 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 3,360 $ 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 /, 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. 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 $ SUMMARY PAGE 81905 0 8X5 0 0 81905 17734 Statement covers periodCALIFORNIA zA illo 10,557 9/22/2013 FORM 77197 from .- .. amounts. If this is the first report being filed through 10/19/2013 Page 3 of 8 I.D. NUMBER 1359636 Column B Calendar Year Summary for Candidates CALENDAR YEAR TOTALTODATE Running in Both the State Primary and General Elections 14368 , 17000 1/1 through 6/30 7/1 to Date 15,368 20. Contributions Received $ $ 21. Expenditures 157368 Made $ $ 81905 0 8X5 0 0 81905 17734 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last 87823 10,557 37360 report. Some amounts in Column A may be negative figures that shoul..- -. from pr- 77197 .- .. 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). I Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (if Subject to Voluntary Expenditure Limit) 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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Sr_hrarli ila A Type or print in ink. SCHEDULE A Moneta Contributions Received Amounts may be rounded Monetary to whole dollars. Statement covers period CALIFORNIA' • 9/22/2013 from 4 8 10/19/2013 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER RANDY WARREN 1359636 AND ZIP FULL NAME, , STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) WIND 9/22!13 Mles JodA00a ❑COM retired 100 100 ❑ OTH an ❑ PTY ❑ ScC ®IND 10/2/13 Deke Welch ❑COM retired 200 200 ❑ OTH San Rafael CA 94901 ❑ PTY ❑ SCC ®IND 10/18/13 n ❑COM Realtor 400 400 ❑ OTH Alain Pinel Realtors San Rafael CA 94903 ❑ PTY ❑ SCC BIND Edmond McGill ❑COM Attorney, McGill Law 100 100 10/7/13 E] OTH Office Ovato, 4949 ❑ PTY ❑ SCC ®IND Art Faibisch A ❑COM Opinion researcher, 10/14/13 E] OTH ADF Research 300 300 ❑ PTY ❑ SCC SUBTOTAL$ 11100 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.) ............. ....I .................. $ ......... $ TOTAL $ 7,570 254 7,824 *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) Type or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 9/22/2013 FORM • from 10/19/2013 5 8 through Page of NAME OF FILER I.D. NUMBER RANDY WARREN 1359636 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED . (IF COMMITTEE, ALSO ENTER LDNUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) MIND Fulcrum Test Preparation & Admissions 10/15/13 Solutions, Inc. ®OTH 490 490 Palo Alto CA 94301 ❑ PTY ❑ SCC AI Dugan OCA Insurance Executive 10/8/13 80 280 ❑ OTH Novato CA 94947 ❑ PTY ❑ SCC ❑ IND 10/18/13 Susan Adams ® COM 1,000 1,000 ❑ OTH San Rafael CA 94903 ❑ PTY ❑ SCC Richard Lawrence OCOM IND Fund manager 10/15/13 F-] OTH Overlook Investments 4,900 4,900 Kentfield CA 94904 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 6,470 '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 C Type or print in ink.. SCHEDULE C Amounts may Derounded Nonmonetary Contributions Received to whole dollars.CALIFORNIA Statement covers period 460 9/22/2013 from FORM 0 8 1011912013 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER RANDY WARREN 1359036 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR {IF COMMITTEE, ALSO ENTER I.D. NUMBER} CODE * (IF SELF-EMPLOYED,, ENTER NAME OF BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR {JAN 1 - DEC 31) SIF REQUIRED) BIND Warren Law Group PC ❑COM cam ai n signs 999 999 1011113 � OTH an Ra ae ❑ PTY r-lscc ❑ INC} ❑ COM F-1 0TH PTY ❑ SCC F-JIND [ J COM ❑ 0TH PTY FISCC F-JIND F_� COM Q 0TH 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.}..................................................................................................................... 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 } *Contributor Codes• COM Recipient• (otherPTY or SCC) ! • ., business entity) PTY — Political Party SCC — Small Contributor i i • Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER RANDY WARREN Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 9/22/2013 through 10/19/2013 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 7 of — 8 I.D. NUMBER 1359636 CNP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants IV TG 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) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Amit Press rubber stamp i6akim San Rafael, CA 94903 41 Citibank bank fee Northgate Drive 10 San Rafael Registrar of Voters voter list Civic Center 24 San Rafael CA * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 1. Itemizedpayments made this period. (include all Schedule E subtotals.) ............................................................. ................................................ $ 3,550 2. Uniternized payments made this period of under $100 ..................................................................................................... .................................... $ 3. Total interestpaid 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 $ 31660 FPPC Form 460 (January/05) .,,:PPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER RANDY WARREN Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 9/22/2013 through 10/19/2013 SCHEDULE E (CONT.) Page 8 of 8 I.D. NUMBER 1359636 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 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 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) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID tin USA Mission Viejo CA pho 447 in lit 3,000 acramento 5816 Warren Law Group PC CMP 138 San Rafael CA 94903 i * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 3,585 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)