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Form 460 - Yes on Measure E (2013-10-22)Recipient Comm iftee Campaign Cover ge M 84200-84216.5) Type or print in ink. Statement covers period from 9/27/2013 SEE INSTRUCTIONS ON REVERSE I through 10/22/2013 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee [] Ballot Measure Committee Q State Candidate Election Committee (g Primarily Formed 0 Recall Q Controlled (Also Complete Part 5) 0 Sponsored ❑ General Purpose Committee (Also complete Part 6) 0 Sponsored r-1 Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1359556 COMMITTEE NAME (OR CANDIDATE'S NAME IF No COMMITTEE) Committee For A Safer San Rafael - Yes On Measure E STREET ADDRESS (NO P.O. BOX) 1000 4th Street Suite 600 CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 415-456-4000 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX 1 E-MAIL ADDRESS 415-456-1921 Date of election if applicable: (Month, Day, Year) 11/5/2013 .0 C, T 2 3 ' 5 is t y % 0 1 e. f •..1 19 - For Official Use Only 2. Type of Statement: ® Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement [❑ Supplemental Preelection ❑ Amendment (Explain below) Statement - Attach Form 495 OPTIONAL: FAX t 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 info ati ontained 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 ?Coect. 10/23/2013 Executed on By 5ate Sign reasurer or Assistant Treasurer Executed on By Date Signature of Controffing ndidate, State Measure Proponent or Respons of Sponsor Executed on By �date, State Measure r e Signature of C � :�, Executed on By FPPC Form 4601 (June/01) Date S�� t'e of C Officeholder, eo, Came, State Measure e P n FPPC Toll -Free Helpline: 866/ASK-FPPC State of California Treasurer(s) NAME OF TREASURER Jeffrey Schoppert MAILING ADDRESS P.Q. Bax 150166 CITY San Rafael STATE CA ZIP CODE 94901 AREA CODE/PHONE 415-456-4000 NAME OF ASSISTANT TREASURER, IF ANY Will LaBranche MAILING ADDRESS P.Q. Box 150166 CITY San Rafael STATE CA ZIP CODE 94903 AREA CODE/PHONE 415-456-4000 OPTIONAL: FAX t 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 info ati ontained 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 ?Coect. 10/23/2013 Executed on By 5ate Sign reasurer or Assistant Treasurer Executed on By Date Signature of Controffing ndidate, State Measure Proponent or Respons of Sponsor Executed on By �date, State Measure r e Signature of C � :�, Executed on By FPPC Form 4601 (June/01) Date S�� t'e of C Officeholder, eo, Came, State Measure e P n FPPC Toll -Free Helpline: 866/ASK-FPPC State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page • rt 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not included in this statement than 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? 0 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 G. Ballot Measure Committee NAME OF BALLOT MEASURE Measure E COVER PAGE - PART 2 Page 2 i of 19 BALLOT NO. OR LETTER JURISDICTION [,K SUPPORT E City of San Rafael ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY 7. Primarily Formed Committee List names of ofhceholder(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 FJOPPOSE Attach continuation sheets if necessary FPPC Fonn 460 (June/01) FPPC Toll -Free Helplines 866/ASK-FPPC State of Califorrila f I Campaign Disclosure Statement Type or print in ink. Amounts may be rounded Summary Page to whole dollars. Statement covers period from 9/27/2013 SUMMARY PAGE Expenditures Made T 0 calculate Column B, add 6. Payments Made ....................................................... Schedule E, Line 4 $ through 10/22/2013 Page 3 Of 19 SEE INSTRUCTIONS ON REVERSE Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F, Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 NAME OF FILER Add Lines 8 + 9 + 10 $ period amounts. If this is the first report being filed I.D.NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 13250 $ .00 $ 41500.00 0 0 1/1 through 6/30 7/1 to Date 2. Loans Received ...................................................... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $ 13250.00 $ 41500.00 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 291.91 291.91 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 13541.91 $ 41791.91 Made $ $ Expenditures Made T 0 calculate Column B, add 6. Payments Made ....................................................... Schedule E, Line 4 $ 7. Loans Made ............................................................. Schedule H, Line 3 8. SUBTOTAL CASH 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 $ Current Gash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 13. Cash Receipts ................................................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ........................... Schedule /, 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 Q, il 19. Outstanding Debts ......................... Add Line 2 + Line 9 in Column B above Q 25145.08 $ 0 25145.08 $ 5000.00 0 35145.08 $ 30833.08 0 30833.08 10000.00 0 40833.08 22562.00 T 0 calculate Column B, add 13250.00 amounts in Column A to the corresponding amounts H from Column B of your last o 25145.08 report. Some amounts in Column A may be negative 10666.92 figures that should be subtracted from previous period amounts. If this is the first report being filed I for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 10000.00 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) *Since January 1, 2001. Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPP( ScheduleA Type or print in ink. SCHEDULE A Moneta Contributions Received Amounts may be rounded Monetary Statement covers period to whole dollars. CALIFORNIA• , from 9/27/2013 - Page 4 of 19 SEE INSTRUCTIONS ON REVERSE 10/22/2013 through NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR T CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE, ALSO ENTER IDNUMBER) , .. CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) 9/27/13 Larry Luckham ®IND ❑COM Fire Commissioner 100 100 ❑OTH San Rafael Fire Sausalito, CA 94965 ❑ PTY Department ❑ SCC 9/30/13 Building Trades Council Let's Build Responsibly IND ®COM 400 400 ❑ OTH San Rafael, CA 94903 ❑ PTY #900667 ❑ SCC 10/3/13 Seagate Properties Inc. ❑❑COM IND 500 500 ®OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 10/3/13 Marin Builders Association PAC IND ®COM 1000 1000 ❑ OTH an a ae , ❑ PTY #1359556 [:]SCC 10/3/13 Denise Jones ®❑IOM IND VP 500 500 ❑OTH Emmanuels Jones & San Rafael, CA 94901 ❑ PTY Associates ❑ SCC SUBTOTAL$ 2500 Schedule A Summary 1. Amount received this period — contributions of $100 or more. (Include all Schedule A subtotals.)......................................................................... 2. Amount received this period — unitemized 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.) . $ 12750 $ 500 ........ TOTAL $ 13250 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) monetary c:ontrawtionS Keceiveci Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA• ' from 9/27/2013 • - Page 5 of 19 through 10/22/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITEE,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) 10/3/13 Deborah Grund ®IND Attorney 100 100 DOTH Self-employed San Rafael, CA 94901 ❑ PTY ❑ SCC 10/6/13 Le I t I ❑X IND ❑ COM Retired 100 100 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 10/6/13 Al Cornwell HIND ❑COM Engineer 500 500 00TH CSW/Stuber-Stroeh San Rafael, CA 94901 ❑ PTY ❑ SCC 10/6/13 William Bagley ©IND ❑COM Attorney 100 100 00TH Nossaman LLP San Rafael, CA 94901 ❑ PTY 0 SCC 10/7/13 Northern California Carpenters ®COM IND 1000 1145.95 ❑0TH Oakland, CA 94621 El PTY #1219354 ❑ SCC SUBTOTAL$ 1800 "Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary GontributionS Received Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA A, from 9/27/2013 • - • Page 6 of 19 through 10/22/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE A FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RES CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED IT (IF COMMITTEE, SO 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) 10/8/13 truction ❑O COM IND 500 500 MOTH San Rafael, CA 94901 ❑ PTY ❑ SCC 10/9/13 Anil Comelo MIND ❑ COM HR Director 100 100 ❑OTH City of San Rafael Orinda, CA 94563 ❑ PTY ❑ SCC 10/10/13 T rr I gjCOM IND Attorney 250 250 ❑OTH Self-employed San Rafael, CA 94901 ❑ PTY ❑ SCC 10/11/13 [-]COM IND Civil Engineer 100 100 OovaOto ❑OTH CSW/Stuber-Stroeh ❑ PTY ❑ SCC 10/16/13 Barbara Heller MIND ❑ COM Retired 100 100 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL$ 1050 'Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) monetary c:ontrioutionS Keceivecf Amounts may be rounded Statement covers period to whole dollars. • - ' 9/27/2013 from • - • pa e 7 of 19 9 through 10/22/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF 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) 10/16/13 All Boro ®❑COM IND Retired 100 100 E3 OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 10/16/13 Andrew McCullough ©IND ❑COM Attorney 250 250 ❑OTH Syufy Enterprises San Rafael, CA 94901 ❑ PTY ❑ SCC 10/16/13 Dorothy Breiner ®IND ❑ COM Retired 100 100 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 10/16/13 Kimley-Horn and Associates, Inc. ❑❑COM 1000 1000 MOTH San Jose, CA 95113 ❑ PTY ❑ SCC 10/16/13 Damo*Connolll for Cit Council 2015 ❑IND M COM 250 250 ❑DTH an 4903 E] PTY #1299079 ❑ SCC SUBTOTAL$ 1700 'Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY— Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars.• CALIFORNIA , from 9/27/2013 • - Page 8 of 19 through 10/22/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IFCOMMITTEE, 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) 10/17/13 Donald Carama no ®❑COM IND Principal 1000 1000 ❑OTH DC Electric Cotati, CA 94931 ❑ PTY ❑ SCC 10/18/13 CRW Systems, Inc. ❑IND ❑ COM 100 100 MOTH Carlsbad, CA 92011 ❑ PTY ❑ SCC 10/18/13 William McDevitt ®IND ❑COM Contractor 250 250 ❑OTH McDevitt Construction Petaluma, CA 94954 ❑ PTY ❑ SCC 10/21/13 Gary Mizono RJCOM IND MD 250 250 ❑OTH Permanente Medical San Francisco, CA 94116 ❑ PTY Group ❑ SCC 10/22/13 Jonathan Frieman ®❑cOM IND Retired 500 500 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL$ 2100 *Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Gontri butions Received Amounts may be rounded Statement covers period to whole dollars. CALIFORNIA from 9/27/2013 FORM • Page 9 of 19 through 10/22/2013 NAMEOFFILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 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. NUMBER) CODE OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TODATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -OEC. 31) (IF REQUIRED) OF BUSINESS) 10/22/13 Patrick Burke MIND Investor 250 250 ❑OTH Self-employed ent Ie , CA 94904 ❑ PTY ❑ SCC 10/2/13 fiji" MIND ❑ COM Executive Director 150 150 ❑OTH Agriculture Institution of San Rafael, CA 94901 ❑ PTY Marin ❑ SCC 9/27/13 Nanc Mackie MIND ❑COM City Manager 200 200 ❑OTH Cit of San Rafael Y San Anselmo, CA 94960 ❑ PTY ❑ SCC 10/22/13 Resource Conservation PAC ®COM IND 3000 3000 ❑OTH San Rafael, CA 94901 ❑ PTY #1347886 ❑ SCC M IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 3600 *Contributor Codes IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC —Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC i Schedule Loans Received Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 0/27/2013 SCHEDULE B - PART 1 i tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 0 $ 0 p Schedule a B Summa Schedde E, Line 3) 1. Loans received this period.................................................................................................................... (Total Column (b) plus unitemized loans less than $100.) *Amounts forgiven or paid by another party also must be 0 reported on Schedule A. 2. Loans paid or forgiven this period......................................................................................................... (Total Column (c) plus loans under 100 paid or forgiven.) ** If required. (Include leans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. Subtract Line 2 from Line 1.) ............................................................... N 0 Enter the net here and on the Summary Page, Column A, line 2. (May be a negative number) t Contributor Cedes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other P -- Political Party SCC -- Small Contributor Committee FPPC Form 460 (June/01 FPPC Toll -Free Helpline. 866/ASIC-FPPC 10/2212013 10 19 SEE INSTRUCTIONS ON REVERSE through Page ______ of NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER T OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE (b) AMOUNT (c) AMOUNT PAID (d) OUTSTANDING (e) INTEREST f ORIGINAL M CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS NAME OF BUSINESS) PERIOD THIS PERIOD* PERIOD PERIOD LOAN TO DATE ❑ PAID CALENDAR YEAR (� FORGIVEN RATE PER ELECTION'" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED DATE DUE ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION ** tQ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED DATE DUE [� PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION i tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 0 $ 0 p Schedule a B Summa Schedde E, Line 3) 1. Loans received this period.................................................................................................................... (Total Column (b) plus unitemized loans less than $100.) *Amounts forgiven or paid by another party also must be 0 reported on Schedule A. 2. Loans paid or forgiven this period......................................................................................................... (Total Column (c) plus loans under 100 paid or forgiven.) ** If required. (Include leans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. Subtract Line 2 from Line 1.) ............................................................... N 0 Enter the net here and on the Summary Page, Column A, line 2. (May be a negative number) t Contributor Cedes IND - Individual COM - Recipient Committee (other than PTY or SCC) OTH - Other P -- Political Party SCC -- Small Contributor Committee FPPC Form 460 (June/01 FPPC Toll -Free Helpline. 866/ASIC-FPPC Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 9/27/2013 SCHEDULE B - PART 2 SEE INSTRUCTIONS ON REVERSE through 10/22/2013 Page 11 of 19 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 FULL NAME, STREET ADDRESS AND ZIP CODE OF GUARANTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) LOAN AMOUNT GUARANTEED THIS PERIOD CUMULATIVE TO DATE BALANCE OUTSTANDING TO DATE IND LENDER CALENDAR YEAR COM $ DATE OTH PTY PER ELECTION (IF REQUIRED) ❑ SCC ❑ IND LENDER CALENDAR YEAR RCOM $ R OTH PER ELECTION (IF REQUIRED) DATE r-1 PTY El SCC $ CALENDAR YEAR E:] IND LENDER [:] COM $ ROTH ❑ PTY PER ELECTION (IF REQUIRED) DATE SCC $ IND LENDER CALENDAR YEAR F_1COM $ F-1 OTH PER ELECTION (IF REQUIRED) DATE PTY SCC F-riter on SUBTOTAL $ 0 Summary Paw, Line 17 FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule C Type or print in ink. SCHEDULE C ­=yuc i QLiil Nonmonetary Contributions Received to whole dollars. Statement covers period from 9/27/2013 CALIFORNIA FORM • Page 12 of 19 SEE INSTRUCTIONS ON REVERSE through 10/22/2013 NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR TO DATE IF REQUIRED NAME OF BUSINESS) (JAN 1 - DEC 31) 10/09/13 Northern California Carpenters ❑IND ©COM Use of Phones; 145.95 1145.95 00TH 10/1 to 10/9 Oakland, CA 94621 ❑PTY #1219354 ❑SCC 10/22/13 Gary Phillips ®IND ❑COM CPA Hosted Event 145.96 1145.96 ❑0TH DZH Phillips LLP San Rafael, California. 94901 ❑ PTY ❑ SCC ❑IND ❑COM ❑ 0TH ❑ PTY ❑ SCC ❑ IND ❑COM ❑OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 291.91 Schedule C Summary 1. Amount received this period — nonmonetary contributions of $100 or more. (Include all Schedule C subtotals.)...................................................................................... 2. Amount received this period — unitemized nonmonetary contributions of less than $100 .. 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) . $ 291.91 ... TOTAL $ 0 291.91 `Contributor Codes IND—individual COM — Recipient Committee (other than PTY or SCC) OTH — Other PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule D SCHEDULEDSumm c''� Ex � of Expenditures � .Type or print in ink. Statement covers period ' Supporting/Opposing+Other Amounts may be rounded dollars. „ ! to whole from 9127/2013 � Candidates, Ii�C'c'�sI�IrE"' and Committees 10/22/2013 13 19 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359550 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, {IF REQUIRED) PERIOD (JAN.1 • DEC. 31) (IF REQUIRED) OR COMMITTEE Monetary Contribution [� Nonmonetary Contribution ❑ Independent Support ❑ Oppose Expenditure Monetary Contribution ❑ Nonmonetary Contribution Independent Support ❑ Oppose Expenditure FPPC Form 460 (June/01 FPPC Toll -Free Helpline: $66/ASK-FPPC d1b Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from 9/27/2013 10/22/2013 14 19 SEE INSTRUCTIONS ON REVERSE through Page Of NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment CW campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals Fly) fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals W independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads V\EB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID TBW13 Strategies I San Francisco, CA 94104 CNS See Schedule G 25124.00 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 25124.00 Schedule E Summary 1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) .................................................................................................. $ 25124.00 2. Uniternized payments made this period of under $100 .......................................................................................................................................... $ 21.08 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ 0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ................. ........... TOTAL $ 25145.08 FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule F Type or print in ink. Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Committee For A Safer San Rafael - Yes On Measure E Statement covers period from 9/27/2013 through 10/22/2013 Page 15 of 19 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 RHO phone banks TRC candidate travel, lodging, and meals FID 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 V\EB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR CODE OR(a) OUTSTANDING AMOUNT INCURRED 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 TBWB Strate *iies CNS 5000 30124 25124 10000 cis an Fansco, * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 5000 $ 30124 $ 25124 $ 10000 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for 30124 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 25124 accrued expenses of $100 or more, plus total uniternized payments on accrued expenses under $100.) ................................ PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and 5000 onthe Summary Page, Column A, Line 9.) ................................................................................................................................................ NET $ May be a negatve number FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 86f/ASIS-FPPC Schedule G Type or print in ink. Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. SEE INSTRUCTIONS ON REVERSE SCHEDULE G Statement covers period from 9/27/2013 through 10/22/2013 Page 16 of 19 NAME OF FILER I I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 NAME OF AGENT OR INDEPENDENT CONTRACTOR TWBW Strategies 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) _ Printing and shipping of lawn signs 2390.00 Richmond, CA 94804 rintinn Printing, Pre -Press and Shipping of Walk cards 4842.00 San Francisco, CA 94111 Printing and mailing Counting cards Political Data, Inc. Data 1,303.60 orwa c, USPS - CAPS POS 1233.42 San Mateo. CA 94497 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 9769.02 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. FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule G Type or print in ink. Payments Made by an Agent or Independent Amounts may be rounded Contractor (on Behalf of This Committee) to whole dollars. Statement covers period from 9/27/2013 through 10/22/2013 Pae 17 of 19 SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359556 NAME OF AGENT OR INDEPENDENT CONTRACTOR TWBW Strategies - Continued CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW 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 PFK) 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 MB 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 PM Cohen Public Affairs San Rafael, CA 94915 CNS 2500.00 Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 2500 Do not transfer to any other schedule oro the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (June/01) independent contractor as reported on Schedule E FPPC Toll -Free Helpline: 866/ASK-FPPC Schedule H Type or print in ink. Statement covers period CALIFORNIA * Loans Made to Others Amounts may rounded dollars. from 9/27/2013 � - 4bAft to whole 10/22/2013 18 19 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Committee For A Safer San Rafael - Yes On Measure E 1359555 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL ENTER(a) OCCUPATION AND EMPLOYER OUTSTANDING BALANCE (b) AMOUNT (c) REPAYMENT OR (d) dN OUTSTANDING AT (e) INTEREST M ORIGINAL (g) CUMULATIVE OF RECIPIENT (IF SELF-EMPLOYED, ENTER BEGINNING THIS LOANED THISBALANCE FORGIVENESS CLOSE OF THIS RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD PERIOD LOAN TO DATE PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION** r 1. Loans made thiseriod................................................................................................................................. .................. � **If Required (Total Column (b) plus unitemized loans less than $100.) 2. Payments received on loans........................................................................................................................................... 0 (Total Column (c) plus unitemized payments less than $100.) . Net change this period. Subtract Line 2 from Line 1.) ........................................................................................ NET 0 (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number) FPPC Form 460 (June/01 FPPC Toll -Free Helpline.- 866/ASK-FPPC L4TW*1W.tff_§1Wx_5M Miscellaneous Increases to Cash Amounts mays rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE Statement covers period from 9/27/2013 through 10/22/2013 CALIFORNIA AM01 FORM 4b Page 19 of 19 NAME OF FILER Committee For A Safer San Rafael - Yes On Measure E I.D. NUMBER 1359556 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 0 Schedule I Summary 1. Increases to cash of $100 or more this period . .......................................................................................................... $ 0 2. Unitemized increases to cash under $100 this period . ............................................................................................. $ 0 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ................................. $ 0 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the 0 SummaryPage, Line 14.) .......................................................................................................................... TOTAL $ FPPC Form 460 (June/01) FPPC Toll -Free Helpline: 866/ASK-FPPC