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Home My WebLink AboutForm 460 - Randy Warren for City Council 2013 (2013-12-26) TerminationRecipient Committee Cam paig In Statement Cover Page (Government •i- Sections 84200-84216.5) Type or print in ink. Statement covers period from 10/20/2013 SEE INSTRUCTIONS ON REVERSE through 12/26/2013 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 Complete Part 5) 0 Sponsored MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored F-] 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 / E-MAIL ADDRESS Loo,fkL Date of election if applicable: (Month, Day, Year) 11/5/2013 COVER PAGE Page 1 of 6 For Official Use Only y 2. Type of Statement: ❑ Preelection Statement Quarterly Statement ❑ Semi-annual Statement Special Odd -Year Report ® Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 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 / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my owledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury undVthawsof t e State of California that the foregoing is true and corre Executed on By Daae Sicgr � asurer orrAwstant Treasurer u Executed on .. By Date Signature of Cour ollin rider, C idat"State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Data Signature of Controlling Officeholder, Candidate, State Measure Pr rent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASIS-FPPC (866/275-3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover • 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 04903 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 ❑ 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? Q YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE KOWA A 9.1yel M.. . Page 2 of 6 BALLOT NO. OR LETTER I JURISDICTION I F -I SUPPORT 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 F-1 SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD � SUPPORT OPPOSE FPPC Form 464 (January/05 FPPC Toll -Free Helpline: 866/ASI{-FPPC 866/275-3772 State of California V Campaign Disclosure Statement Summary Page Type or print in ink. 2_1 Amounts may be rounded to whole dollars. Statement covers period from 10/20/2013 - SUMMARY PAGE Expenditures Made To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last 2,809 0 through 12/26/2013 Page 3 of 6 SEE INSTRUCTIONS ON REVERSE 7. Loans Made ............................................................. Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 8,736 $ NAME OF FILER 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 0 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 I.D. NUMBER RANDY WARREN 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 8,736 17,641 1359636 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD ATTACHED SCHEDULES) CALENDAR YEAR DATE Running in Both the State Primary and (FROM TOTALTO General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 21 809 $ $ 17177 , 0 17000 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines I + 2 $ 2,809 $ 18,177 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0 999 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 2,809 $ 19,176 Made $ $ Expenditures Made To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last 2,809 0 6. Payments Made ....................................................... Schedule E, Line 4 $ 8,736 $ 17,641 7. Loans Made ............................................................. Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 8,736 $ 17,641 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 0 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 8,736 17,641 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. 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 $ 5,898 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last 2,809 0 8,707 report. Some amounts in Column A may be negative figures that should be subtracted from previous 0 period amounts. If this is the first report being filed 0 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 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) A Schedule A Monetary Contributions Received CALIFOIRNM 460 10/20/2013 FOR. w..�. FOR r Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ........................................................................................................ 2. Amount received this period — uniternized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. Lines Enter here t ® Summary TOTAL i 27700 *Contributor.• - i — Individua COM Recipient Committee (otherPTY or OTH ! • business SmallPTY — Political Party • • • : Form 460 (January/05) r P * a i � •Helpline:a • • (866/275-3772) 12/25/2013 4 6 SEE INSTRUCTIONS ON REVERSE thfou,%h 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 I. D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND 10/30/13 Art Faibisch F1COM Opinion researcher, 200 500 ❑ OTH ADF Research San Rafael CA 94901 ❑ PTY F-1 SCC ❑IND 1 0124113 San Rafael Yacht Harbor F-1 COM 27500 27500 ®OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC F-] IND ❑ COM ❑ OTH ❑ PTY ❑SCC E]IND ❑ COM ❑ OTH ❑ PTY ❑SCC Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) ........................................................................................................ 2. Amount received this period — uniternized monetary contributions of less than $100 ............................. $ 3. Total monetary contributions received this period. Lines Enter here t ® Summary TOTAL i 27700 *Contributor.• - i — Individua COM Recipient Committee (otherPTY or OTH ! • business SmallPTY — Political Party • • • : Form 460 (January/05) r P * a i � •Helpline:a • • (866/275-3772) Type or print in ink. bcnedule E Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER RANDY WARREN Statement covers period from 10/20/2013 through 12/26/2013 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 7 of 6 I.D. NUMBER 1359636 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 RHO 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 MB 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 Avery Media TEL 1,000 Marin Independent Journal 4000 Civic Center Drive PRT 37673 San Rafael CA 94903 Comcast Petaluma CA TEL 2,526 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7,109 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ 3,636 2. Uniternized payments made this period of under $100 .......................................................................................................................................... $ 71 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ 0 A R I I I ZI 111 1; � III �! 111 11 ■a 595 1 1 A � WARM I Ism 40 ��t-firllow 'EnTorol MLIAH&S1 � FPPC Form 460 (January/05) 'FPPC To# -Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule E Type or print in ink. (Continuation Sheet) Amounts may be rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME luii OF FILER RANDY WARREI Statement covers period from 10/20/2013 through 12/26/2013 Page 8 of (i I.iiia ii i� i D. NUMBER 1359636 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphernalia/misc. IVIBR 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 CODE OR I DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Target Marketing USA 22981 Calle Azorin Mission Viejo CA pho 1079 Warren Law Group PC PO Box 6285 cmp 358 San Rafael CA 94903 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,437 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)