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HomeMy WebLinkAboutForm 460 - Gary Phillips for Mayor 2015 (2015-06-30)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print In ink. Statement covers period from January 1, 2015 through June 30, 2015 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee Q State Candidate Election Committee 0 Primarily Formed Q Recall Q Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored Q Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information ;OMMITTEE NAME (OR CANDIDATE'S I Gary Phillips for Mayor 2015 ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1376443 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX 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 certify under penalty of perjury under the laws of the State of California that the fore I Executed on July 30, 2015 By Executed on July o—�', 2015 By s Executed on Data By Date of election if applicable: (Month, Day, Year) November 3, 2015 JUL 3 0 2015 Time: City Clerk's City of San 2. Type of Statement: ❑ Preelection Statement j� Semi-annual Statement ❑ Termination Statement ❑ Amendment (Explain below) COVER PAGE Page 1 of 10 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Richard Kalish MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 ( NAME OF ASSISTANT TREASURER. IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX / E-MAIL ADDRESS rkalish@kalishnexon.com I my knowledge the information contained herein and in the attached schedules is true and complete. Is d correc� Executed on Junel0l 460 By FPPC Form Date SignafureafContragmgOfAoehalder. Candidate, 5tateMeasure Praponent ( ) FPPC Toll -Free Helpline: 866/ASK-FPPC State of California Type or print in ink. COVER PAGE -PART 2 Recipient Committee CALIFORNIA Campaign Statement FORM 460 Cover Page — Part 2 S. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Gary Phillips OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Mayor, City of San Rafael RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 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. COMMITfEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURERI CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Page 2 of 10 6. Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTERI JURISDICTION I E]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 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 ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 666/ASK-FPPC State of California Campaign Disclosure Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from January 1, 2015 SUMMARYPAGE Expenditures Made through June 30, 2015 Paye 3 of 10 SEE INSTRUCTIONS ON REVERSE 0 0 7. Loans Made............................................................. Schedule H. Line 3 NAME OF FILER 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 3568 I.D. NUMBER Gary Phillips for Mayor 2015 0 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 1376443 0 0 Column Column B Calendar Year Summary for Candidates Contributions Received Current Cash Statement TOTALTHISPERiOD CALENDARYE4R Primary Running r�tl in Both the State Prima and 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ (FROM ATTACHED SCHEDULES) TOTALTO DATE General Elections 16750 6750 6750 1. Monetary Contributions ........................................... Schedule A, Linea $ $ 1/l through 6/30 7i1 to Date from Column B of your last 10000 10000 report. Some amounts in 2. Loans Received...................................................... Schedule e, Line 3 Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 13182 16750 16750 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ $ Received $ $ period amounts. If this is 0 0 the first report being filed for this calendar year, only 4. Nonmoneta Contributions .................................... ry schedule C, Line 3 $ 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED••••••••••••............••• Add Lines 3+4 $ 16750 $ 16750 Made $ $ 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column a above Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 3568 $ 3568 0 0 7. Loans Made............................................................. Schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 3568 $ 3568 9. Accrued Expenses (Unpaid Bills) ............................... Schedule FLine 3 0 0 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8+9+10 $ 3568 $ 3568 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 0 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 16750 amounts in Column A to the 0 corresponding amounts 14. Miscellaneous Increases to Cash ........................... schedule 1, Line 4 from Column B of your last 3568 report. Some amounts in 15. Cash Payments .................................................. Column A, Line 8above Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 13182 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed for this calendar year, only 0 17. LOAN GUARANTEES RECEIVED ........................... Schedule B. Part 2 $ carry over the amounts any) Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 0 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column a above $ 10000 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (M Subject to Voluntary Expenditure Limit) Date of Flection Total to Date (mm/dd/yy) —�� $ $ —�J $ $ 'Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC �+_1J„§„ A Type or print in ink. SCHEDULE A Amounts may be rounded Monetary Contributions Received to whole dollars.• Statement covers period ' January 1, 201 0 - E from through June 30, 2015 page 4 of 10 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2015 1376443 DATE ZIP FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR S AIF DDRESS CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (EET SAND I.D.NUMBER) CODE * QFSELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 6/22/15 Joe Ayoob ®❑IoM IND Retired 150 150 ❑OTH San Rafael, CA 94903 ❑ PTY ❑ SCC 6/20/15 William Brody ®[]COM IND Life insurance agent 750 750 ❑OTH Brody, Walsh, Brody San Rafael, CA 94903 ❑ PTY ❑ SCC 6/20/15 Diversified Equity Holdings []IND ❑COM 500 500 ®OTH San Rafael, CA 94912 ❑ PTY ❑ SCC 6/22/15 William Bagley ®IND Retired 100 100❑COM ❑0TH San Rafael, CA 94901 ❑ PTY ❑ SCC 6/22/15 Richard Matthews ®IND ❑ COM Retired 250 250 ❑OTH San Rafael, CA 94903 ❑ PTY ❑ SCC SUBTOTAL$ 1,750 Schedule A Summary 'Contributor Codes 1. Amount received this period — contributions of $100 or more. IND—Individual 6,600 COM—Recipient Committee (Include all Schedule A subtotals.)........................................................................................................ $ (other than PTY or SCC) 2. Amount received this period — unitemized contributions of less than $100 ............................................. $ 150 OTH—Other PTY—Political Parry 3. Total monetary contributions received this period. t SCC—small contributor committee (Add Lines 1 and 2. Enter here and on the Summa Page, Column A, Line 1. ... TOTAL $ 6,750 Summary Cl g ) """��������� �� � FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Tvpeorprint inink SCHEDULEA (CONT.) Monetary Contributions Received Amounts maybe rounded dollars. Statement covers period�. NIA 460 to whole January 1, 2015 • - from through June 30, 2015 Page 5 of 10 NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2015 .1376443 DATE FULL NAME, STREET ADDRESS AND 7JP 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 COMMaTEE. ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) 6/22/15 Gordon Manashil MIND IND Retired 250 250 KOTH San Rafael, CA 94901 ❑ PTY ❑SCC 6/22/15 James Placak KIND ❑COM Retired 250 250 ❑OTH San Rafael, CA 94903 ❑ PTY ❑ SCC 6/22/15 Dennis Fisco KKIND IND Attorney 250 250 ❑NTH Seagate Properties Mill Valley, CA 94941 ❑ PTY ❑SCC 6/22/15 Gary Mizono KKIND IND Physician 500 500 ❑OTH Kaiser Permanente San Francisco, CA 94116 ❑ PTY ❑SCC 6/22/15 Jack Nixon ©IND ❑COM Self employed 750 750 KOTH Jack Nixon Insurance San Rafael, CA 94901 ❑ PTY ❑SCC SUBTOTAL$ 2,000" "' •==�r V 'Contributor Codes IND—Individual COM—Recipient Committee (other than PTY or SCC) OTH — Other PTY —Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 1366/ASK-FPPC Schedule A (Continuation Sheet) Type or.printinInk. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. January 1, 2015 ' • - from through June 30, 2015 Page 6 of 10 NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2015 1376443 DATE ADDRESSZIP 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 OF CTAAMIDRE CODE * OF SELF-EMPLOYED. ENTER NAM E PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) 6/30/15 Neil Moran ®IND ❑COM Attorney 250 250 oTH Freitas, McCarthy❑ San Rafael, CA 94901 ❑ PTY [:]SCC 6/24/15 Craig Yates ©INDSelf employed 250 250 ooTH Craig Yates General San Rafael, CA 94903 ❑ PTY Contractor ❑ SCC 6/24/15 Fred Levinson MIND DRetired EICOM 250 250 ❑OTH San Francisco, CA 94115 ❑ PTY ❑SCC 6/24/15 Joan Thayer ®❑COM Retired 100 100 ❑OTH San Rafael, CA 94903 ❑ PTY ❑ SCC 6/24/15 Marge Bartolini ®IND ❑ Retired 250 250 ❑OTH TH Novato, CA 94945 ❑ PTY ❑ SCC SUBTOTAL 1,100 4•;;. .r : = ts' ::; F,. ,'i k`,'!U:':`:. �.ic,.��'S.. =r.. kiR#!S�''•: .. rare=: `Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC—Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. January 1, 2015 I ' • - from Page 7't 10 through June 30, 2015 NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2015 1376443 DATE ZIPDEO 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, ALSOAND I.D.N CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 6/26/15 San Rafael Airport LLC ❑IND ❑COM 750 750 400 F Smith Ranch Road ®oTH San Rafael, CA 94903 El PTY ❑SCC 6/26/15 James Schafer ®IND ❑ COM Developer 250 250 ❑OTH Samualson Schafer Kentfield, CA 94904 ❑ PTY ❑SCC 6/26/15 Ma lora & Ghilotti 99 ❑IND ❑COM 750 750 ®OTH San Rafael, CA 94901 ❑ PTY ❑SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑SCC ❑ IND ❑COM ❑ OTH ❑ PTY ❑SCC SUBTOTAL$ 1,750' - 'Contributor Codes IND—Individual COM —Recipient Committee (other than PTY or SCC) OTH — Other PTY—Political Party SCC—Small Contributor Committee FPPC Form 460 (June/01) FPPC Toil -Free Helpline: B66/ASK-FPPC SCHEDULEB-PART1 Schedule B —Part 1 Amounts -may ... be.rounded Statement coversperiod . Loans Received to whole dollars. January 1, 2015 . - • from June 30, 2015 8 10 SEE INSTRUCTIONS ON REVERSE through page of NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2015 1376443 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER a OUTSTANDING (b) AMOUNTOUTSTANDING (c) AMOUNTPAID ld) (e) INTEREST (r) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IFSEIF-EMPLOYED ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IF COMMITTEE. ALSO ENTER I.D. NUMBER) NAMEOF BUSINESS PERIOD PERIOD THIS PERIOD' PERIOD PERIOD LOAN TO DATE Gary Phillips Mayor of San Rafael E] PAID CALENDARYEAR $ 0 5 10000 0% $ 10000 $ PER ELECTION - San Rafael, CA 94903 E] FORGIVEN RATE 0 0 s 10000 s 0 a 0 4/13/2015 s DATE DUE DATEINCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR 3 5 9S S 3 ❑ FORGIVEN PERELECTION- RATE 5 S 5 S S DATEDUE DATE INCURRED tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC - ❑ PAID CALENDARYEAR S 5 % S S []FORGIVEN PER ELECTION'" PATE 5 5 5 5 S DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 10000 $ 0 $ 10000 $ 0 = tt'rp_F 1{ r `:y �I F.,!_ � Schedule B Summary 1. Loans received this period.................................................................................................................... $ (Total Column (b) plus unitemized loans less than $100.) 2. Loans paid or forgiven this period......................................................................................................... $ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 10000 0 3. Net change this period. Subtract Line 2 from Line 1. ... NET $ 10000 Enter the net here and on the Summary Page, Column A, Line 2. (Maybe a negative number) t Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY —Political Party SCC—Small Contributor Committee toner lel an Schedule E, Line 3) `Amounts forgiven or paid by another party also must be reported on Schedule A. If required. FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from January 1, 2015 through June 30, 2015 SCHEDULEE Page 9 of 10 NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2015 1376443 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalialmisc. MR 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 I.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 (intemet, e-mail) NAME AND ADDRESS OF PAYEE (IFCOMMITTEE-ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID n PM Cohen Public Affairs Box 150268 CNS 2000 San Rafael, CA 94915 four waters media, Inc. 3093 Lassen Street CNS 1000 Sacramento, CA 95691 Four Waters Media, Inc. 3093 Lassen Street LIT 405 Sacramento, CA 95691 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 3405 Schedule E Summary 1. Payments made this period of $100 or more. Include all Schedule E subtotals. $ 3518 2. Un itemized payments made this period of under $100 ............................ $ 50 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 $ 3568 FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPFC Schedule E CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Big Cat Advertising 10 Commercial Blvd., Suite 210 Novato, CA 94949 CMP SCHEDULE E (CONT.) Statement covers period 0. , PI ' Type or print in Ink. (Continuation Sheet) Amounts may be rounded Payments Made to whole dollars. from January 1, 2015 •' June 30, 2015 10 10 - SEE INSTRUCTIONS ON REVERSE through Pae of g NAME OF FILER I.D. NUMBER Gary Phillips for Mayor 2015 1376443 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MM 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 filingiballot 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 M independent expenditure supportinglopposing 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 Lrr campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMnTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Big Cat Advertising 10 Commercial Blvd., Suite 210 Novato, CA 94949 CMP 113 ` Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 113 FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC