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Home My WebLink AboutForm 460 - Rachel Kertz for Board of Education 2018 2nd Preelection StatementRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 09/23/2018 through 10/20/2018 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 5i 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee InformationI I.D. NUMBER 1410420 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Rachel Kertz for Board of Education 2018 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Roseville CA 95661 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX STATE ZIP CODE AREA CODEIPHONE OPTIONAL: FAX / E-MAIL ADDRESS ( COVER PAGE S0E0d Date of election if applica I (Month, Day, Year) OCT 2 5 2018 1 of 19 or Official Use Only 11/06/2018 ,IT y , 01 FI 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 ( NAME OF ASSISTANT TREASURER. IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: F AX I 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. J Executed on 10/24/2018 By Date Executed on 10/24/2018 By Date Executed on Dale Executed on www.netfile.com By Signature of Controlling Officeholder, Candidate, State Measure Proponent Date 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 6. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Rachel Kertz OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Board of Education: City of San Rafael RESIDENTIALIBUSINESS 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. COMMITTEENAME 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'? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE www.nettile.com COVER PAGE - PART 2 Page 2 of 19 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTERI JURISDICTION 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 Listnamesof 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 2018 Contributions Received 1. Monetary Contributions ........................ 2. Loans Received ................................... 3. SUBTOTALCASH CONTRIBUTIONS- 4. ONTRIBUTIONS..4. Nonmonetary Contributions ................. 5. TOTAL CONTRIBUTIONS RECEIVED . Amounts may be rounded to whole dollars. Expenditures Made Column A Schedule E. Line 4 $ 7. Loans Made............................................................. TOTALTHIS PERIOD 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6 + 7 $ (FROM ATTACHED SCHEDULES) ................ Schedule A, Line $ 1,600.00 11. TOTAL EXPENDITURES MADE ................................ ................ Schedule B, Line 3 10,400.00 .................... Add Lines 1 +2 $ 12, 000.00 ................ Schedule C, Line 3 0.00 ....................... Add Lines 3+4 $ 12,000.00 Expenditures Made 6. Payments Made ....................................................... Schedule E. Line 4 $ 7. Loans Made............................................................. Schedule H. Line 3 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8+9+10 $ SUMMARY PAGE Statement covers period from 09/23/2018 through _..... 10/2.0/2018 _ Page 3 of 19 I.D NUMBER 1410420 Column B Calendar Year Summary for Candidates CALENDAR Runningin Both the State Prima and TOTALTO DATE Primary General Elections $ 3,529.00 1/1 through 6/30 711 to Date 14,106.16 $ 17,635.16 0.00 $ 17,635.16 16,554.09 $ 0.00 16,554.09 $ -7,475.56 0.00 9,078.53 $ Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 5,568.90 13. Cash Receipts ................................................... Column A, Line 3above 12,000.00 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 0.00 15. Cash Payments .................................................. Column A, Line s above 16,554.09 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 1,014.81 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 $ www.netfile.com 0.00 0.00 16.888.08 16,620.35 0.00 16,620.35 2,781.92 0.00 19,402.27 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period 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). 20. Contributions Received $ $ 21. Expenditures Made $ $ 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Srrhrarh da A SCHEDULE A -- -- - Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA 460 from 09 23 20ic FORM through 10/20/2018 Page 4 of 19 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 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 (E COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 10/03112018 Democratic Central Committee of Marin i;ID# ❑IND 100.00 100.00 761428) ❑COM ❑ OTH Sacramento, CA 95841 ❑x PTY ❑ SCC 10 11/2018 Julie Fingersh ❑RIND Writer 100.00 100.00 ❑ COM Julit Fingersh San Rafael, CA 94903 ❑ OTH ❑ PTY []SCC 10/14/2018 Cathy Goldstein [g]IND Retired 250.00 250.00 [-]COM n/a San Rafael, CA 94901 ❑ OTH ❑ PTY []SCC 10/11/2018 Marie Henrio ❑x IND Data Analyst 100.00 100.00 [-]COM San Rafael City Schools San Anselmo, CA 94960 ❑ OTH ❑ PTY []SCC 09F30/2018 Geza Kadar [g]IND Retire 200.00 450.00 ❑COM n/a Santa Rosa, CA 95404 ❑ OTH ❑ PTY []SCC SUBTOTAL$ 750.00 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.neffile.com $ 1,350.00 ................. $ TOTAL $ 250.00 1,600.00 *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 (8661275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) SCHEDULE A (CONT) Monetary Contributions Received Amounts may be rounded Statement covers period • to whole dollars. , from 09/23/2018 • ' through 10/20/2018 page 5 of 19 NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBEM CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSI NESS) 10/18/2018 Geza Kadar x❑IND Retired 250.00 450.00 ❑ COM Santa Rosa, CA 95404 ❑ OTH ❑ PTY ❑ SCC 10/17/2018 Marin Women's PAC (ID# 1332045) ❑IND X❑ COM San Rafael, CA 94903 ❑ OTH ❑ PTY ❑ SCC 10/19/2018 Sarah Schoening x❑IND Program Advisor 250.00 ❑COM Coldwell Banker Portland, OR 97210 ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 60( *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 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Schedule B — Part 1 Amounts may be rounded Statement covers period CALIFORNIA 460 Loans Received to Whole dollars. 09/23/2018 FORM from SEE INSTRUCTIONS ON REVERSE through 10/20/2018 Page 6 Of 19 NAME OF FILER I.D. NUMBER Rachel Kertz for Board of Education 2018 1410420 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUALENTER , a OUTSTANDING (b) AMOUNTAMOU (c) NT PAID (d) OUTSTANDING (e) INTEREST () ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNTOF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE Rachel Kertz Director of Strategic ❑ PAID CALENDAR YEAR Programs San Rafael, CA 94903 Belvedere Tiburon S 0.00 $ 206.16 0.00 % S 206.16 $ 14,106.16 Library Foundation RATE E] FORGIVEN PER ELECTION** S 206.16 S 0.00 S 0.00 12/31/2019 $ 0.00 09/11/2018 S DATE DUE DATE INCURRED t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Rachel Kertz Director of Strategic ❑ PAID CALENDARYEAR Programs San Rafael, CA 94903 Belvedere Tiburon S 0.00 $ 3,500.00 0.00 % S 3,500.00 $ 14,106.16 Library Foundation RATE ❑ FORGIVEN PER ELECTION — 5 3,500.00 S 0.00 S 0.00 03/19/2018 $ 0.00 09/19/2018 5 DATE DUE t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED Rachel Kertz Director of Strategic ❑ PAID CALENDAR YEAR Programs San Rafael, CA 94903 Belvedere Tiburon S 0.00 S 3,000.00 0.00 % $ 3,000.00 $ 14,106.16 Loan Library Foundation RATE ❑ FORGIVEN PER ELECTION*' S 0.00 S 3,000.00 $ 0.00 12/31/2019 $ 0.00 10/01/2018 S I I DATE DUE DATE INCURRED tFX] IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 3,000.00$ 0.00$ 6,706.16$ 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 $ 10,400.00 $ 0.00 .................. NET $ 10,400.00 (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 (8661276-3772) www.fppc.ca.gov SCHEDULE B - PART 1 (CONT.) Schedule B - Part 1 (Continuation Sheet) Amounts may be rounded Statement covers period _ Loans Received to whole dollars. CALIFNIA � . 1 from 09/23/201e • SEE INSTRUCTIONS ON REVERSE through 10/20/2018 Page 7 of 19 I.D. NUMBER NAME OF FILER Rachel Kertz for Board of Education 2018 1410420 IF AN INDIVIDUAL, ENTER a (b) (c) FULL NAME, STREET ADDRESS AND ZIP CODE OUTSTANDING AMOUNT AMOUNTPAID (d) OUTSTANDING (e) INTEREST V) ORIGINAL (g) CUMULATIVE OCCUPATION AND EMPLOYER BALANCE OF LENDER RECEIVED THIS OR FORGIVEN (IF SELF-EMPLOYED, ENTER BEGINNING THIS BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD` PERIOD PERIOD LOAN TO DATE Rachel Kertz Director of Strategic ❑ PAID CALENDAR YEAR Programs San Rafael, CA 94903 Belvedere Tiburon S 0.00 S 3,900.00 0.00 % 3,900.00 S 14,106.16 Loan Library Foundation ❑FORGIVEN RATE PER ELECTION"{ S 0.00 $ 3,900.00 S 0.00 04/04/2019 S 0.00 10/04/2018 S DATE DUE DATE INCURRED t® IND [_1 COM [_1 OTH ❑ PTY ❑ SCC Rachel Kertz Director of Strategic ❑ PAID CALENDARYEAR Programs San Rafael, CA 94903 Belvedere Tiburon S 0.00 $ 3,500.00 0.00 % S 3,500.00 S 14,106.16 Loan Library Foundation ❑ FORGIVEN RATE PER ELECTION** S 0.00 S 3,500.00 S 0.00 S 0.00 10/15/2018 S DATE DUE DATE INCURRED tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR S S % S S ❑ FORGIVEN PERELECTION" RATE $ S S 5 S DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR S S % S S ❑ FORGIVEN PER ELECTION"" RATE S S S S $ DATE DUE DATE INCURRED t ❑ IND ❑COM ❑ OTH ❑PTY ❑SCC SUBTOTALS $ 7,400.00$ 0.00$ 7,400.00$ 0.00 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. www.netfile.com 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 (8661275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 2G 1k Amounts may be rounded to whole dollars. Statement covers period from 09/23/2018 through 10/20/2018 I Page 8 of 19 LD 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 LD NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID CJ & Associates, Inc. PRO 490.51 Roseville, CA 95661 CJ & Associates, Inc. PRO 206.16 Roseville, CA 95661 Cornerstone Printing, Inc. POS 960.98 Tiburon, CA 94920 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,657.65 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 16, 472.29 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 81.80 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).)............................................................................... $ 0.00 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 16, 554.09 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.fppc.ca.gov www.netfile.com Schedule E (Continuation Sheet) 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 a 2018 SCHEDULE E Page 9 of 19 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 candidatelsponsor 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 DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER 10 NUMBER) Four Waters Media, Inc. 150.00 West Sacramento, CA 95691 Four Waters Media, Inc. WEB 900.00 West Sacramento, CA 95691 Four Waters Media, Inc. 950.00 West Sacramento, CA 95691 Four Waters Media, Inc. CNS 100.00 West Sacramento, CA 95691 Four Waters Media, Inc. - 800.00 West Sacramento, CA 95691 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. www.netfile.com SUBTOTAL $ 2,900.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIO NAME OF FILER Amounts may be rounded to whole dollars. Statement covers period from 09/23/2018 through 10/20/2018 SCHEDULE E Page 10 of 19 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. CNP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants NrrG 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 DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Four Waters Media, Inc. WEB 750.00 West Sacramento, CA 95691 Four Waters Media, Inc. LIT 1,666.01 West Sacramento, CA 95691 Four Waters Media, Inc. I LIT West Sacramento, CA 95691 Four Waters Media, Inc. CMP West Sacramento, CA 95691 Four Waters Media, Inc. WEB West Sacramento, CA 95691 305.68 700.00 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 5,733.90 www.neffile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) 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 09/23/2018 through 10/20/2010 SCHEDULE E Page 11 of .... 1.9 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 LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I D NUMBER) Four Waters Media, Inc. CNS 450.00 West Sacramento, CA 95691 Four Waters Media, Inc. LIT 2,260.15 West Sacramento, CA 95691 Four Waters Media, Inc. LIT 353.17 West Sacramento, CA 95691 PMCohen Public Affairs CNS 500.00 San Rafael, CA 94901 PMCohen Public Affairs WEB 617.42 San Rafael, CA 94901 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. www.netfile.com SUBTOTAL $ 4,180.74 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made Amounts may be rounded to whole dollars. Statement covers period from 09/23/20.a SCHEDULE E through ;e/2c/2'V!R Page 12 of 19 SEE INSTRUCTIONS ON REVERSE 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. CMP campaign paraphemalia/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 PMCohen Public Affairs San Rafael, CA 94901 CNS 1,000.00 PMCohen Public Affairs San Rafael, CA 94901 CNS 1,000.00 " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,000.00 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) www.fppe.ca.gov Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTI NAME OF FILER Rachel Kertz for Board of Education 2018 Amounts may be rounded to whole dollars. Statement covers period from 09/23/2018 SCHEDULEF through 10/20/2018 I of Page 13 19 I.D. NUMBER 1410420 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVIP 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 SUBTOTALS $ 2,824.05$ 0.00$ 2,824.05$ 0. DD 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.)................................................................... 2,781.92 10,257.48 ...................................................... NET $ -7,475.56 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 f ( (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANIXNG 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 CS & Associates, Inc. PRO 206.16 0.00 206.16 0.00 Roseville, CA 95661 Four Waters Media, Inc. LIT 305.68 0.00 305.68 0.00 West Sacramento, CA 95691 Four Waters Media, Inc. CMP 2,312.21 0.00 2,312.21 0.00 West Sacramento, CA 95691 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 2,824.05$ 0.00$ 2,824.05$ 0. DD 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.)................................................................... 2,781.92 10,257.48 ...................................................... NET $ -7,475.56 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) Amo towholunts ybllars. ed Statement covers period to whole dollars. Accrued Expenses (Unpaid Bills) from 09;23/2018 through 10/20/2018 OF FILER Rachel Kertz for Board of Education 2018 SCHEDULE F (CONT.) Page 14 of 19 I.D. NUMBER 1410420 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CHIP 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. SUBTOTALS $ 3,666.01$ 0.00$ 3,666.01 $ 0.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov www.netfile.com (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNTINCURRED AMOUNTPAID 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 Four Waters Media, Inc. LIT 1,666.01 0.00 1,666.01 0.00 West Sacramento, CA 95691 Four Waters Media, Inc. CNS 150.00 0.00 150.00 0.00 West Sacramento, CA 95691 Four Waters Media, Inc. LIT 950.00 0.00 950.00 0.00 West Sacramento, CA 95691 Four Waters Media, Inc. WEB 900.00 0.00 900.00 0.00 West Sacramento, CA 95691 SUBTOTALS $ 3,666.01$ 0.00$ 3,666.01 $ 0.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule F (Continuation Sheet) Amounts may be rounded Statement covers period to whole dollars. Accrued Expenses (Unpaid Bills) from 09/23/2018 through 10/20/2018 NAME OF FILER Rachel Kertz for Board of Education 2018 SCHEDULE F (CONT.) Page 15 of 19 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 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. www.netfile.com SUBTOTALS $ 2,217.42$ 0. 0o$ 2,217.42 $ 0.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov ( ( (c) ( 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 rALSOREPORT ONE) OF THIS PERIOD PMCohen Public Affairs CNS 500.00 L. i 500.00 0.00 San Rafael, CA 94901 PMCohen Public Affairs CNS 1,000.00 0.00 1,000. 0.00 San Rafael, CA 94901 PMCohen Public Affairs WEB 7.42 617.42 0.00 San Rafael, CA 94901 Four Waters Media, Inc. CNS 100.00 0.00 100.00 0.00 West Sacramento, CA 95691 www.netfile.com SUBTOTALS $ 2,217.42$ 0. 0o$ 2,217.42 $ 0.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule F SCHEDULE F (CONT) (Continuation Sheet) Amounts may be rounded Statement covers period • to whole dollars. _ • Accrued Expenses (Unpaid Bills) from 09 23:2018 through 10/20/2018 Page 16 Of 19 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. 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. www.netfile.com SUBTOTALS $ 1,550.00$ 581.92$ 1,550.00 $ 581.92 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov (a) (b) (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNTINCURRED AMOUNTPAID 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 Four Waters Media, Inc. WEB 750.00 0.00 750.00 0.00 West Sacramento, CA 95691 Four Waters Media, Inc. LIT 800.00 0.00 800.00 0.00 West Sacramento, CA 95691 PMCohen Public Affairs WEB 0.00 472.67 0.00 472.67 San Rafael, CA 94901 PMCohen Public Affairs LIT 0.00 109.25 0.00 109.25 San Rafael, CA 94901 www.netfile.com SUBTOTALS $ 1,550.00$ 581.92$ 1,550.00 $ 581.92 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule F (Continuation Sheet) Amounts may be rounded Statement covers period to whole dollars. Accrued Expenses (Unpaid Bills) from 09/23/2018 through 10/20/2018 NAME OF FILER Rachel Kerte for Board of Education 2018 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE F (CONT.) Page 17 Of 19 I.D. NUMBER 1410420 CNP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants NITG 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 summarized on Schedule D. 700.Or NAME AND ADDRESS OF CREDITOR CODE OR (a) OUTSTANDING (b) AMOUNT INCURRED (c) AMOUNT PAID (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 1,000.00 0.00 1,000.00 San Rafael, CA 94901 Four Waters Media, Inc.—IS 500.00 U.01 500.00 West Sacramento, CA 95691 Four Waters Media, Inc. WEB 0 ci0 700.Or 700.00 West Sacramento, CA 95691 www.netfile.com SUBTOTALS $ 0.00$ 2,200.00$ 0.0o $ 2,200.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 2018 NAME OF AGENT OR INDEPENDENT CONTRACTOR Cornerstone Printing, Inc. Amounts may be rounded to whole dollars. HEDULE G Statement covers period from 09/23/2018 through 10/20/2018 Page— 18 of 19 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 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 United States Post Office Belvedere Tiburon, CA 94920 POS 960.98 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 960.98 * 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.neffile.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 Contractor (on Behalf of This Committee) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 201B NAME OF AGENT OR INDEPENDENT CONTRACTOR Four Waters Media, Inc. Amounts may be rounded to whole dollars. Statement covers period from 09/23/2018 through 10/20/2018 SCHEDULE G Page 19 Of 19 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 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 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 Cornerstone Printing, Inc. Tiburon, CA 94920 LIT 2,260.15 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 2,260.15 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