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HomeMy WebLinkAboutForm 460 - Rachel Kertz for Board of Education 2018 1st Preelection StatementRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 01/01/2018 through 09/22/2018 1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. ❑x Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part 5) Q Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information i I.D. NUMBER Rachel Kertz for Board of Education 2018 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE Roseville CA 95661 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX COVER PAGE � te[11 Date of election if applica SEP 2 7 ?_918 (Month, Day, Year) LJ 1 of .. 119F r Official Use Only 11/06/2018 ITY CLERK'S OFF CE 2. Type of Statement: ❑x 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 Chelsea Johnson MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Roseville CA 95661 ( AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY ( CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS ( 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 knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. / I/ Executed on 09/27/2018 Date Executed on 09/27/2018 Date Executed on Date Executed on Date www.netfile.com By By By Signature of Controlling Officeholder, Candidate, Slate Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Rachel Kertz OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER I JURISDICTION I ❑ SUPPORT Board of Education: City of San Rafael ❑ OPPOSE RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. San Rafael CA 94903 NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT Related Committees Not Included in this Statement: Listany committees not included in this statement that are controlled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? [I YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) [TP/M:illMR] MWTI:JIM Page _ of 12 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE 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 CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) WWW.netfile.com www.fppc.ca.gov Campaign Disclosure Statement SUMMARY PAGE Page Amounts may be rounded to whole dollars. Statement covers period CALIFORNIASummary / ' from _ 01. 01, 2018 O through 09/22/2018 Page 3 of 12 SEE INSTRUCTIONS ON REVERSE ^I NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDAR YEAR r Running in Both the State Primary and (FROMATTACHED SCHEDULES) TOTALTO DATE g General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 1,929.00 $ 1,929.00 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule B, Line 3 3,706.16 3,706.16 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ 5,635.16 $ 5,635.16 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0.00 0.00 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+4 $ 5,635.16 $ 5,635.16 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ....................................................... Schedule E, Line $ 66.26 $ 66.26 Candidates 7. Loans Made............................................................. Schedule H, Line 3 0.00 0.00 22. Cumulative Expenditures Made* 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ 66.26 $ 66.26 (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 8,607.48 8,607.48 Date of Election Total to Date 10. Nonmonetary Adjustment .......................................... Schedule C, Line 0.00 0.00 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE ................................ Add Lines a+s+10 $ 8,673.74 $ 8,673.74 $ $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 0.00 To calculate Column B, add 13. Cash Receipts ................................................... Column A, Line 3 above 5,635.16 amounts in Column A to the corresponding amounts *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 0.00 from Column B of your last reported in Column B. 15. Cash Payments ................ Column A, Line a above 66.26 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 5,568.90 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 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 $ 0.00 for this calendar year, only ........................... carry over the amounts Cash Equivalents and Outstanding Debts g from Lines 2, 7, and 9 (if q any). 18. Cash Equivalents ........................................ See instrucdons on reverse $ 0.00 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above $ 12,313.64 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov www.netfile.com Schedule A SCHEDULE A Moneta Contributions Received Amounts may ne rounoeo �/ to dollars. Statement covers period CALIFORNIA whole from 01/01/2018 FORM page 4 of 12 through 09/22/2018 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 DATE A O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RE,ALSAND ZIP CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED IT _D, NUMBER) (IF COMMITTEE, CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBUSINESS) 09/17/2018 Aaron Bortel MIND Attorney 200-00 200.00 ❑ OTH ❑ PTY ❑ SCC 09/04/2018 AJ Brady MIND Deputy District Attorney 250.00 250.00 ❑ OTH ❑ PTY ❑ SCC 09/08/2018 Avis Caravello MIND Legal Search Consultant 100.00 100.00 ❑ OTH ❑ PTY ❑ SCC 09/22/2018 Jeffrey Dorsey MIND Certified Public 100.00 100.00 Jeffrey Dorsey ❑ OTH ❑ PTY ❑ SCC 0 97 10 2018 Andrew Ellison MIND Analyst 150.00 150.00 ❑ OTH ❑ PTY ❑ SCC 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 $100 ........... 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) .................. www.netfile.com SUBTOTAL$ 1300. „ $ 1,408.00 TOTAL $ 521.00 1,929.00 '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 A (Continuation Sheet) SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period ' to whole dollars. I 4 , from 01/01/2018 through 09/22/2018 Page5 of 12 !MB NAMEOFFILER I.D. NUER Rachel Kertz for Board of Education 2018 1410420 AND DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PER ELECTION TO DATE RECEIVED (E COMMITTEE, ALSO LD NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 09/16/2018 Maxine Epsteinx❑IND Social Work 100.00 100.00 Foundation ❑ OTH ❑ PTY ❑ SCC 09/15/2018 Michelyn Russell French X❑IND Office Manager 200.00 200.00 Foundation ❑ OTH ❑ PTY ❑ SCC 09/16/2018 Bruce Gribens RIND CPA 108.00 108.00 ❑ OTH ❑ PTY ❑ SCC 09/15/2018 Arlan H. Kertz RIND Retired 100.00 100.00 ❑ OTH ❑ PTY ❑ SCC 0 Christopher Owen X❑IND Financial Services 100.00 100.00 ❑ OTH ❑ PTY ❑SCC SUBTOTAL$ 608.00 '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 www.netfile.com SCHEDULEB-PART1 Schedule B — Part 1 Amounts may be rounded Statement covers period Loans Received to whole dollars. CALIFORNIA 460 from 01/01/2018 FORM SEE INSTRUCTIONS ON REVERSE through 09/22/2018 Page 6 of 12.. NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING (b) AMOUNTAMOUNT (c) PAID (d) OUTSTANDING (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IFSELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IFCOMMITTEE, ALSO ENTER I.D.NUMBER) NAME OF BUSINESS) PERI D PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE Rachel Kertz Director of Strategic ❑ PAID CALENDARYEAR Belvedere Tiburon S 0.00 S 206.16 .00 $ 206.16 $ 3,706.16 Library Foundation ❑ FORGIVEN RATE PERELECTION** $ 0.00 S 206.16 S 0.00 12/31/2019 0.00 09/11/2018 $ DATE DUE DATE INCURRED t© IND ❑COM [-] OTH ❑ PTY ❑ SCC Rachel Kertz Director of Strategic ❑ PAID CALENDARYEAR Belvedere Tiburon S 0.00 S 3,500.00 0.00 % S 3,500.00 S 3,706.16 Library Foundation RATE ❑ FORGIVEN PER ELECTION *" S 0.00 S 3,500.00 $ 0.00 03/19/2018 0.00 09/19/2018 S DATE DUE DATE INCURRED tQ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR $ S % S $ ❑ FORGIVEN PERELECTION** RATE S S S S S DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 3,706.16$ 0.00$ 3,706.16$ 0.00 Schedule B Summary 1. Loans received this period................................................................................... (Total Column (b) plus unitemized loans of 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.) 3. Net change this period. (Subtract Line 2 from Line 1.) .......................................... Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. www.netfile.com $ 3,706.16 0 NET $ 3,706.16 (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor 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 E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 2018 Amounts may be rounded to whole dollars. Statement covers period from through 09/22/2018 Page 7 of 12 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1410420 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 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).................................................................................... 2. Unitemized payments made this period of under $100................................................................................................................ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ..................................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ................ www.netfile.com AMOUNT PAID SUBTOTAL $ 0.00 $ 0.00 $ 66.26 ......... $ 0.00 ...... TOTAL $ 66.26 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 2018 Amounts may be rounded to whole dollars. Statement covers period from 01/01/2018 through 09/22/2018 SCHEDULEF Page_ a_ of 12 I.D. NUMBER 1410420 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 UT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0.00$ 2 , ` 4. 5$ 0.00$ 2,824.05 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................. PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)................................................................ 8,607.48 0.00 ..................................................... NET $ r 98, 607.48 May be a negative number FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.netfile.com www.fppc.ca.gov ( ( (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTAA NDING AMOUNTIN CURRED AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD CJ & Associates, Inc. PRO 0.00 206.16 0.00 206.16 Four Waters Media, Inc. LIT 0.00 305.68 0.00 305.68 Four Waters Media, Inc. CMP 0.00 0.00 2,312.21 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 0.00$ 2 , ` 4. 5$ 0.00$ 2,824.05 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) ................................. PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.)................................................................ 8,607.48 0.00 ..................................................... NET $ r 98, 607.48 May be a negative number FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.netfile.com www.fppc.ca.gov Schedule F (Continuation Sheet) Accrued Expenses (Unpaid Bills) NAME OF FILER Rachel Kertz for Board of Education 2018 Amounts may be rounded to whole dollars. Statement covers period from 011,01j20'18 through 09/22/2018 SCHEDULE F (CONT.) Page 9 of 12 I.D. NUMBER 1410420 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. C(uIP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants N 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 UVEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. ( ( (c) ( NAME AND ADDRESS OF CREDITOR CODE OR OUTSTAA NDING AMOUNT IN NCURRED AMOUNTPAID OUTSTANDING (IF COMMITTEE, ALSO ENTER '.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) € OF THIS PERIOD Four Waters Media, Inc. LIT 0.00 1,666.01 0.00 1,666.01 Four Waters Media, Inc. CNS 0.00 150.00 0.00 150.00 Four Waters Media, Inc. LIT 0.00 950.00 0.00 950.00 Four Waters Media, Inc. WEB 0.00 900.00 0.00 900.00 www.netfile.com SUBTOTALS $ 0.00$ 3,666.01$ 0.00 $ 3,666.01 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) www.fppc.ca.gov Schedule F SCHEDULE F (CONT) (Continuation Sheet) Amounts may be rounded Statement covers period • - to whole dollars. � t Accrued Expenses (Unpaid Bills) from 01/01/2018 ' - through 09/22/2018 Page 10 of 12 NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CWP 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. 0.00 617.42 NAME AND ADDRESS OF CREDITOR CODEOR (a) OUTSTANDING (b) AMOUNT INCURRED (c) AMOUNTPAID (d) OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD PMCohen Public Affairs CNS 0.00 500.00 0.00 500.00 PMCohen Public Affairs CNS 0.00 1,000.00 0.00 1,000.00 PMCohen Public Affairs WEB 0.00 617.42 0.00 617.42 www.neifile.com SUBTOTALS$ 0.00$ 2,117.42$ 0.00$ 2,117.42 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule G SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers period •1 Contractor (on Behalf of This Committee) to whole dollars. from 0' O11 2018 - SEE INSTRUCTIONS ON REVERSE through 09/22/2018 Page 11 of 12 NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 NAME OF AGENT OR INDEPENDENT CONTRACTOR Four Waters Media, Inc. 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) " Payments that are contributions or independent expenditures must also be summarized on Schedule D. Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 1,724.38 Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 2018 NAME OF AGENT OR INDEPENDENT CONTRACTOR PMCohen Public Affairs Statement covers period from 01/41/2018 through 09/22/2018 Page 12 of 12 I.D. NUMBER 1410420 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 FIND 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Political Data, Inc. WEB 500.00 Attach additional information on appropriately labeled continuation sheets. * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. www.netfile.com TOTAL" $ 500.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov