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Home My WebLink AboutForm 460 - Rachel Kertz for Board of Education 2018 (Termination)Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Statement covers period from 10/21/20.8 SEE INSTRUCTIONS ON REVERSE Ithrough 12/27/2018 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. ❑x Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Parry/Central Committee (Also Complete Part 7) 3. Committee Information 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 CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS ( COVERPAGE Date of election if applicabli JAN 3 1 201 Pa LJ (Month, Day, Year) of 13 For C fficial Use Only 11/06/2018- CITY CLERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement ] Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑x 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 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 penally of perjury under the laws of the State of Califomia that the foregoing is true and correct. Executed on 12/27/2018 Date Executed an 12/27/2018 Date Executed on Executed on Date www.netfile.com .r By ,,;Signature of Treasurer or Assistant Treasurer i By Sngnatureof Controlling Officeholder, Candidate, State Measure Proponent ar Responsible ORcerof Sponsor By Signature of Controlling Officeholder, Candidate, Stale Measure Proponent By Signature of Controlling Officeholder. Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (8661275-3772) 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) Board of Education: City of San Rafael RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP San Rafael CA 94903 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (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 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE www.netfile.com COVER PAGE - PART 2 Page 2 of 13 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION [:]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 ❑ 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 (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement SUMMARY PAGE Amounts may be rounded Statement covers period � Summary Page to whole dollars. A A from 10/21/2018 Expenditures Made To calculate Column B, add 5,895.89 through 12/27/2018 Page 3 of 13 SEE INSTRUCTIONS ON REVERSE 7. Loans Made............................................................. Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ NAME OF FILER 23,531.05 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 -2,781.92 I.D. NUMBER Rachel Kertz for Board of Education 2018 Schedule C, Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE ................................Add 1410420 4,128.78 $ 23,531.05 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTALTHIS PERIOD CALENDAR YEAR Running in Both the State Primaryand (FROM ATTACHED SCHEDULES) TOTALTO DATE g General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 $ 20,002.05 $ 23,531.05 1/1 through 6/30 7/1 to Date 2. Loans Received...................................................... Schedule B, Line 3 -14,106.16 0.00 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 $ 5,895.89 $ 23,531.05 20. Contributions ......................... Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 0.00 0.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 5,895.89 $ 23,531.05 Made $ $ Expenditures Made To calculate Column B, add 5,895.89 6. Payments Made ....................................................... Schedule E, Line 4 $ 6,910.70 $ 23,531.05 7. Loans Made............................................................. Schedule H, Line 3 0.00 0.00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7 $ 6,910.70 $ 23,531.05 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 -2,781.92 0.00 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 0.00 0.00 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 4,128.78 $ 23,531.05 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 $ www.neffile.com 1,014.81 To calculate Column B, add 5,895.89 amounts in Column A to the corresponding amounts from Column B of your last 0.00 6,910.70 report. Some amounts in Column A may be negative 0.00 figures that should be subtracted from previous period amounts. If this is the first report being filed 0.00 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 0.00 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 Schedule SCHEDULE A ►mounts may oe rounaea Monetary Contributions Received to dollars. Statement covers p eriod CALIFORNIA whole 460 from 10/21/2018 FORM Page 4 of 13 SEE INSTRUCTIONS ON REVERSE through 12/27/2018 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 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 10/29/2018 Nanci E. Buck BIND Retired 250.00 250.00 ❑ OTH ❑ PTY ❑ SCC 12/27/2018 Rachel Kertz ❑x IND Director of Strategic 1,695.89 19,702.05 MOTH [:]PTYFoundation ❑ SCC 12/27/2018 Rachel Kertz ❑X IND Director of Strategic 3,900.00 19,702.05 ❑ OTH Foundation ❑ PTY ❑ SCC 12/27/2018 Rachel Kertz MIND Director of Strategic 206.16 19,702.05 MOTH Foundation ❑ PTY ❑ SCC 12/27/2018 Rachel Kertz OIND Director of Strategic 3,500.00 19,702.05 MOTH Belvedere Tiburon Library Foundation M PTY ❑ SCC SUBTOTAL $ 9, 552.05 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.)........................................................................................................ $ 19, 952.05 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.) ....................... TOTAL $ www.netfile.com 50.00 20,002.05 *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) Monetary Contributions Received Amounts may be rounded to whole dollars. SCHEDULE A (CONT.) Statement covers period from 10/21/2018 through 12/27/2018 Page 5 of 13 *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.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) 12/27/2018 Rachel Kertzx❑IND Director of Strategic 3,500.00 19,702.05 [:]OTH Foundat ion ❑ PTY ❑ SCC 12/27/2018 Rachel Kertz FIND Director of Strategic 3,900.00 19,702.05 Foundation ❑ PTY ❑ SCC 12/27/2018 Rachel Kertz RIND Director of Strategic 3,000.00 19,702.05 MOTH Foundation ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 10,400.00 *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 www.neffile.com FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule B — Part 1 Loans Received Amounts may be rounded to whole dollars. Statement covers period from 10/21/2018 SCHEDULE B - PART 1 SEE INSTRUCTIONS ON REVERSE through 12/27/2018 Page 6 of 13 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 a OUTSTANDING (b) AMOUNTOUTSTANDING (c) AMOUNT PAID (d) (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN gALANCEAT 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 Belvedere Tiburon $ 0.00 $ 0.00 0.00 % $ 3,500.00 $ 19, 702.05 Library Foundation RATE Q FORGIVEN PER ELECTION ** $ 3,500.00 $ 0.00 $ 3,500.00 03/19/2018 $ 0.00 09/19/2018 $ DATE DUE t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED Rachel Kertz Director of Strategic ❑ PAID CALENDAR YEAR Library Foundation RATE ® FORGIVEN PER ELECTION ** $ 3,000.00 $ 0.00 $ 3,000.00 12/31/2019 $ 0.00 10/01/2018 $ DATE DUE I t@ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC I I I I DATE INCURRED SUBTOTALS $ 0.00$ 6,706.16$ 0.00$ 0.00 (Enter (e) on Schedule B Summary Schedule E, Line 3) 1. Loans received this period.................................................................................................................... $ -5,595.89 (Total Column (b) plus unitemized loans of less than $100.) tContributor Codes IND - Individual 2. Loans paid or forgiven this period......................................................................................................... $ 19,702.05 COM — Recipient Committee (Total Column (c) plus loans under $100 paid or forgiven.) (other than PTY or SCC) (Include loans paid by a third party that are also itemized on Schedule A.) OTH - Other (e.g., business entity) PTY — Political Party 3. Net ( chane this eriod. Subtract Line 2 from Line 1.)............................................................... NET $ -14,106.16 SCC — Small Contributor Committee g p Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative number) Amounts forgiven or paid by another party also must be reported on Schedule A * If required. 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 (CONT.) Schedule B — Part 1 (Continuation Sheet) Amounts may be rounded Statement covers period to dollars. • 1 Loans Received whole 10/21/2018 _ • from SEE INSTRUCTIONS ON REVERSE through 12/27/2018 Page 7 of 13 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 a OUTSTANDING (b) AMOUNTOUTSTANDING (c) AMOUNT PAID (d) (e) INTEREST (f) ORIGINAL (g) CUMULATIVE OCCUPATION AND EMPLOYER OF LENDER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN 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 Library Foundation RATE ❑X FORGIVEN PER ELECTION" $ 3,900.00 $ 0.00 $ 3,900.00 04/04/2019 $ 0.00 10/04/2018 $ DATE DUE to IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED Rachel Kertz Director of Strategic ❑ PAID CALENDAR YEAR Library Foundation RATE [nFORGIVEN PER ELECTION ** $ 3,500.00 $ 0.00 $ 3,500.00 $ 0.00 10/15/2018 $ DATE DUE t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED Rachel Kertz Director of Strategic ❑ PAID CALENDAR YEAR Library Foundation ❑X FORGIVEN RATE PER ELECTION $ 0.00 $ 3,900.00 $ 3,900.00 $ 0.00 11/01/2018 $ DATE DUE t@ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED Rachel Kertz Director of Strategic ❑ PAID CALENDAR YEAR Belvedere Tiburon $ 0.00 $ 0.00 0.00 % $ 1,695.89 $ 19, 702.05 Library Foundation RATE 0 FORGIVEN PER ELECTION � $ 0.00 $ 1,695.89 $ 1,695.89 05/05/2019 $ 0.00 12/05/2018 $ DATE DUE t IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED SUBTOTALS $ 5,595.89$ 12, 995.89 $ 0.00$ 0.00 *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. 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.netfile.com 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 10/21/2018 through 12/27/2018 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE E Page 8 of 13 I.D. NUMBER 1410420 CIVP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Anedot, Inc. OFC 20.60 Anedot, Inc. OFC 2.30 Anedot, Inc. OFC 2.30 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 25.20 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 6,910.70 2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 0.00 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 $ 6,910.70 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov www.netfile.com Schedule E (Continuation Sheet) Amounts may be rounded Statement covers period Payments Made to whole dollars. from 10/21/2018 SEE INSTRUCTIONS ON REVERSE I through 12/27/2018 NAME OF FILER Rachel Kertz for Board of Education 2018 SCHEDULE E(CONT) Page 9 of 13 I.D. NUMBER 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 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) CJ & Associates, Inc. PRO 634.12 CJ & Associates, Inc. PRO 500.00 Cornerstone Printing, Inc. POS 242.65 Four Waters Media, Inc. CNS 500.00 Four Waters Media, Inc. WEB 700.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,576.77 www.neffile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E(CONT) (Continuation Sheet) Amounts may be rounded Statement covers period _ to dollars. � - � • • Payments Made from 10/21/2018 12/27/2018 h SEE INSTRUCTIONS ON REVERSE through page 10 of 13 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) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Four Waters Media, Inc. CNS 1,000.00 PMCohen Public Affairs LIT 109.25 PMCohen Public Affairs WEB 472.67 PMCohen Public Affairs CNS 11000.00 PMCohen Public Affairs WEB 163.87 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,745.79 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.netfilexom www.fppc.ca.gov Schedule E SCHEDULE E(CONT) (Continuation Sheet) Amounts may be rounded Statement covers periodA • . A illi to whole dollars. • - Payments Made from 10/21/2018 SEE INSTRUCTIONS ON REVERSE through 12/27/2018 Page 11 Of 13 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. CIVP 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 l_IT camnaian literature and mailinas 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) PMCohen Public Affairs WEB 62.94 PMCohen Public Affairs CNS 500.00 PMCohen Public Affairs CNS 1,000.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1,562.94 www.netfile.com FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule F Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Rachel Kertz for Board of Education 2018 fro Statement covers period m 10/21/2018 through 12/27/2018 SCHEDULE F Page 12 Of 13 I.D. NUMBER 1410420 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphernalia/misc. MBR member communications RAD radio airlime 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 $ 1,581.92$ 0.00$ 1,581.92$ 0.00 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 $ 0.00 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 $ 2,781.92 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)................................................................................................................................................ NET $ -2, 781.92 May be a negative number www.netfile.com 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 AMOUNT INCURRED 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 PMCohen Public Affairs WEB 472.67 0.00 472.67 0.00 PMCohen Public Affairs LIT 109.25 0.00 109.25 0.00 PMCohen Public Affairs CNS 1,000.00 0.00 1,000.00 0.00 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 1,581.92$ 0.00$ 1,581.92$ 0.00 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 $ 0.00 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 $ 2,781.92 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)................................................................................................................................................ NET $ -2, 781.92 May be a negative number www.netfile.com 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• A a to whole dollars. _ 0 Accrued Expenses (Unpaid Bills) from 10/21/2018 through 12/27/2018 Page of 13 13 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. CNP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants NffG 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 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 Four Waters Media, Inc. CNS 500.00 0.00 500.00 0.00 Four Waters Media, Inc. WEB 700.00 0.00 700.00 0.00 www.netfile.com SUBTOTALS $ 1,200.00$ 0.00$ 1,200.00 $ 0.00 FPPC Form 460 (Jan/2016) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov