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Home My WebLink AboutForm 460 - Rachel Kertz for City Council 2024 (12-31-24)Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 10/20/2024 through 12/31/2024 1. Type of Recipient Committee: All committees - Complete Parts 1, 2, 3, and 4. Q Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ State Candidate Election Committee Committee ❑ Recall ❑ Controlled (Also Complete Part 5) ❑ Sponsored (Also Complete Part 6) General Purpose Committee Sponsored I Small Contributor Committee I_ I Political Party/Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1473447 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE Novato CA 94945 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS Date of election if appli (Month, Day, Year) 11/05/2024 JAN 31 2025 1TY CLERK'S 0 COVER PAGE Of 7 Fir Official Use Only CE ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Tamara Hull MAILING ADDRESS Executed on 1/30/2025 Date Executed on Date Executed on Date By By Signature of Controlling Officeholder, Candidate, State 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 IFAPPLICABLE) City Council, City of San Rafael, District 4 RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP Novato CA 94945 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMI i I EF? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE COVER PAGE - PART 2 Page 2 of 7 6. Primarilv 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 Listnames 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 Amounts may be rounded SUMMARY PAGE to whole dollars. Summa PaStatement covers period •- I Page from 10/20/2024 • - ' NAME OF FILER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 Expenditures Made 17020.00 Column A Contributions Received Schedule e, Line 4 TOTAL THIS PERIOD 7. Loans Made ................ ................................ Schedule H, Line 3 (FROM ATTACHED SCHEDULES) 1. Monetary Contributions................................................... Schedule A, Line 3 $ 200.00 2. Loans Received................................................................ Schedule e, Line 3 0 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 200.00 4. Nonmonetary Contributions........ .................................... Schedule C, Line 3 0 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 200.00 Expenditures Made 17020.00 Received $ 6. Payments Made................................................................ Schedule e, Line 4 $ 10424.84 7. Loans Made ................ ................................ Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 10424.84 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 1500.00 10. Nonmonetary Adjustment....................................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 3+9+10 $ 11924.84 Current Cash Statement 17020.00 Received $ 12. Beginning Cash Balance Previous Summary Page, Line 16 $ 15994.16 13. Cash Receipts ...... Column A, Line 3 above $ 200.00 14. Miscellaneous Increases to Cash ..... ........................ Schedule 1, Line 4 0 15. Cash Payments......................................................... Column A, Line 6 above -10424.84 16. ENDING CASH BALANCE ..................Add lines 12 + 13 + 14, then subtract Line 15 $ 5769.32 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part2 $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line s in Column B above $ 1500.00 through 12/31/2024 Page 3 of 7 Column B CALENDAR YEAR TOTAL TO DATE $ 23935.00 0 0. 23935.00 0 $ 23935.00 $ 18165.68 0 $ 18165.68 1500.00 0 $ 19665.68 To calculate Column B, add amounts in Column Ato 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). I.D. NUMBER 1473447 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions 6915.00 17020.00 Received $ $ 21 Expenditures 183.29 19482.39 Mad$ $ 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 A Amounts may be rounded SCHEDULE A to whole dollars. Monetary Contributions Received Statement covers period CALIFORNIA from 10/20/2024FORM • through 12/31/2024 Page 4 of 7 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 FULL NAME, STREETADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 11/12/2024 North Bay Leadership Council PAC ❑ IND FPPC #1246290 200.00 200.00 200.00 Z COM 2350 Kerner Blvd., Suite 250 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 200.00 Schedule A Summary 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.). $ 200.00 $0 ....TOTAL $ 200.00 `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 E Amounts may be rounded Payments Made to whole dollars. Statement covers period from 10/20/2024 6Y91C1:11111111:8q through 12/31/2024 Page 5 of 7 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 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) Complete Digital LLC CNS Ad production, digital ads 5000.00 1317 Potomac Ave SE SAI__L_'__a.__ Tl '1n COPS Voter Guide LIT Mailers 450.00 PO Box 214006 Senior Advocate LIT Mailers 500.00 22410 Hawthorne Blvd., Suite 5 l A nn r. nr. IY Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 5950.00 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.) ................. 10115.85 308.99 ...................... $ 0 ......... TOTAL $ 10424.84 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 Amounts may be rounded to whole dollars. Statement covers period 10/20/2024 from through 12/31/2024 SCHEDULE E (CONT.) Page 6 of I.D. NUMBER 1473447 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID YWCA Silicon Valley MTC Marin Women's Hall of Fame community event 600.00 375 South Third Street O__T--- -A A -1n Andre Charles CNS Consulting 261.24 l n -0 1 Press Print, Inc. LIT Mailers 1749.48 34428 Yucaipa Blvd., Suite E238 �A -nn Press Print, Inc. POS Postage for mailers 1555.13 34428 Yucaipa Blvd., Suite E238 13 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4165.85 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEF Schedule F Amounts may be rounded to whole dollars. from Statement covers period M- �• 'Accrued Expenses (Unpaid Bills) 10/20/2024 gol through 12/31/2024 SEE INSTRUCTIONS ON REVERSE Page 7 of 7 NAME OF FILER I.D. NUMBER Committee to Re-elect Rachel Kertz for San Rafael City Council 2024 1473447 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. SUBTOTALS $ 0 $ 1500.00 $ 0 $ 1500.00 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 1500.00 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, pILIS total unitemized payments on accrued expenses under $100.).. PAID TOTALS $ 0 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 1500.00 onthe Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ - May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov (a) (b) (c) (d) NAMEANDADDRESS 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 Amy Lopez, CNS 0 1000.00 0 1000.00 Sacramento, CA 95816 p CNS Just Gus, Inc., c/o David Checel, 0 500.00 0 500.00 11037 Westwood Blvd., Culver City, CA 9230 p Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ 0 $ 1500.00 $ 0 $ 1500.00 Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 1500.00 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, pILIS total unitemized payments on accrued expenses under $100.).. PAID TOTALS $ 0 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 1500.00 onthe Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ - May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov