Date of election if applicable, (Month, Day, v f, July Dec Iii1! o. Treasurer(s) NAMt=OF-ffiEASURER MAILING ADDRESS CITY

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1 Recipient Cmmittee Campaign Statement Cver Page I 1. Type f Recipient Cmmittee: frm July thrugh Dec Date f electin if applicable, (Mnth, Day, v f, ' ' 2. Type f Statement: All Cmmittees - Cmplete Parts 1, 2, 3, and 4. Officehlder, Candidate Cntrlled Cmmittee State Candidate Electin Cmmittee Recall (Als Cmplete Pert 5) General Purpse Cmmittee Spnsred Small Cntributr Cmmittee Plitical Party!Central Cmmittee Iii1! Primarily Frmed Ballt Measure Cmmittee Cntrlled Spnsred (Als Cmplete Part 6) Primarily Frmed Candidate! Officehlder Cmmittee Preelectin Statement Semi annual Statement Terminatin Statement (Als file a Frm 410 Terminatin) Quarterly Statement Special Odd-Year Reprt Amendment (Explain belw) (Als Cmptet. Part 7) 1.0. NUMBER 3. Treasurer(s) NAMt=OF-ffiEASURER ANDREW ROGERSON San Rafael Firefighters Plitical Awamess Cmmittee MAILING ADDRESS STREET ADDRESS (NO P.O. BOX) ROHNERT PARK San Rafael Ca Ca San Rafael NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CA MAILING ADDRESS OPTIONAL: FAX I ADDRESS OPTIONAL: FAX I ADDRESS 4. Verificatin I have used all reasnable diligence in preparing and reviewing this statement and t the best f my knwledge the certify under penalty f pe ury uljder the laws f the State f Califrnia that the freglatrts'true and crrect. Executed n!.,,...'.- -, Executed n Date Executed n Oale Executed n Date y B- - \ y <:=» (t'inn""t...,,' f"'.... jnfrmcntained herein and in the attached schedules is true and cmplete. \.. SlgnalUre f Trea5urej<\li"',8 i;lsaut:u!!stj!er.,f'... It.." I"\Ff'k-hnfAar (,..""n..ri.r4""t... C:f,.,.t"" l..jft"" De-'""'... e ;,.,la nm,...",r... r c:."","c'nr By Signature f CntrOlling Officehlder, Candidale, State Measure Prpnent By Signature f CntrOlling Officehlder, Candidate, State Measure Prpnent FPPC Frm 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gv (866/ )

2 Campaign Disclsure Statement Summary Page San Rafael Firefighters Plitical Awarness Cmmittee Cntributins Received 1. Mnetary Cntributins Schedule A, Line 3 2. Lans Received..... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS... Add Lines Nnmnetary Cntributins... Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED... Add Lines Amunts may be runded t whle dllars. ClumnA TOTAL THIS PERIOD (FROM ATIACHED SCHEDULES) Clumn B CALENDAR YEAR TOTAL TO DATE frm July SUMMARY PAGE thrugh Dec Page 2 f 5 _ 1.0. NUMBER Calendar Year Summary fr Candidates Running in Bth the State Primary and General Electins 1/1 thrugh 6/30 7/1 t Date 20. Cntributins Received Expenditures Made ---- Expenditures Made 6. Payments Made Schedule =, Line 4 7. Lans Made... Schedule H, Line 3 8. SUBTOTAL CASH PAyMENTS... Add Lines Accrued Expenses (Unpaid Bills)... Schedule F, Line Nnmnetary Adjustment Schedule C, Line TOTAL EXPENDITURES MADE... Add Lines B Expenditure Limit Summary fr State Candidates 22. Cumulative Expenditures Made* (If Subjct t Vluntary Expndlture Umit) Date f Electin (mm/dd/yy) Ttal t Date ---- Current Cash Statement 12. Beginning Cash Balance... Previus Summary Page, Line Cash Receipts... Clumn A, Line 3 abve 14. Miscellaneus Increases t Cash... Schedule I, Line Cash Payments... Clumn A, Line 8 abve 16. ENDING CASH BALANCE... Add Lines , then subtract Line 15 If this is a terminatin statement, Line 16 must be zer. 17. LOAN GUARANTEES RECEIVED... Schedule B, Part 2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructins n reverse 19. Outstanding Debts... Add Line 2 + Line 9 in Clumn B abve 87, ,421 T calculate Clumn B, add amunts In Clumn A t the crrespnding amunts frm Clumn B f yur last reprt. Sme amunts in Clumn A may be negative figures that shuld be subtracted frm previus perid amunts. If this is the first reprt being filed fr this calendar year, nly carry ver the amunts frm Lines 2, 7, and 9 (if any) Amunts in this sectin may be different frm amunts reprted in Clumn B. FPPC Frm 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gv (866/ )

3 Schedule A Mnetary Cntributins Received Amunts may be runded t whle dllars. frm July12017 SCHEDULE A San Rafael Firefighters Plitical Awarness Cmmittee thrugh Dec Page 3 f 5 DATE RECEIVED FULL NAME, STREET ADDRESS AND OF CONTRIBUTOR I CONTRIBUTOR (IF COMMITIEE.ALSO ENTER 1.0. NUMBER) CODE * IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) Schedule A Summary DPTY DPTY OIND OCOM OPTY OSCC DpTY OSCC OIND DpTY SUBTOTAL 1. Amunt received this perid - itemized mnetary cntributins. (Include all Schedule A subttals.) Amunt received this perid - unitemized mnetary cntributins f less than Ttal mnetary cntributins received this perid. (Add Lines 1 and 2. Enter here and n the Summary Page, Clumn A, Line 1.)... TOTAL 0 r I 'Cntributr Cdes IND - Individual COM - Recipient Cmmittee (ther than PTY r SCC) OTH - Other (e.g., business entity) PTY - Plitical Party SCC - Small Cntributr Cmmittee FPPC Frm 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gv (866/ )

4 Schedule E Payments Made Amunts may be runded t whle dllars. frm July SCHEDULE E thrugh Dec Page _4 f 5_ San Rafael Firefighters Plitical Awarness Cmmittee CODES: If ne f the fllwing cdes accurately describes the payment, yu may enter the cde. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member cmmunicatins RAD radi airtime and prductin csts CNS campaign cnsultants MTG meetings and appearances RFD returned cntributins CTB cntributin (explain nnmnetary)' OFC ffice expenses SAL campaign wrkers' salaries CVC civic dnatins PET petitin circulating TEL t.v. r cable airtime and prductin csts FIL candidate filing/ballt fees PHO phne banks TRC candidate travel, ldging, and meals FNO fundraising events POL plling and survey research TRS staff/spuse travel, ldging, and meals INO independent expenditure supprting/ppsing thers (explain) POS pstage, delivery and messenger services TSF transfer between cmmittees f the same candidate/spnsr LEG legal defense PRO prfessinal services (legal, accunting) VOT vter registratin LIT campaign literature and mailings PRT print ads WEB infrmatin technlgy csts (internet, ) NAME AND ADDRESS OF PAYEE (IF COMMITIEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID SAN RAFAEL FIRE FOUNDATION SAN RAFAEL FIRE FOUNDATION CRAB FEED CVC PAC TABLE.00 - * Payments that are cntributins r independent expenditures must als be summarized n Schedule D. SUBTOTAL.00 Schedule E Summary 1. Itemized payments made this perid. (Include all Schedule E subttals.) Unitemized payments made this perid f under Ttal interest paid this perid n lans. (Enter amunt frm Schedule B, Part 1, Clumn (e).) Ttal payments made this perid. (Add Lines 1, 2, and 3. Enter here and n the Summary Page, Clumn A, Line 6.)... TOTAL FPPC Frm 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gv (866/ )

5 Schedule I Miscellaneus Increases t Cash Amunts may be runded t whle dllars. frm July SCHEDULE I thrugh Dec Page _5 f_5 San Rafael Firefighters Plitical Awarness Cmmittee DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMmEE, ALSO ENTER 1.0. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH 12/31/17 BANK OF AMERICA TH ST SAN RAFAEL CA INTEREST EARNED 9 Attach additinal infrmatin n apprpriately labeled cntinuatin sheets, SUBTOTAL 9 Schedule I Summary 1. Itemized increases t cash this perid Unitemized increases t cash f under 100 this perid Ttal f all interest received this perid n lans made t thers. (Schedule H, Clumn (e).) Ttal miscellaneus increases t cash this perid. (Add Lines 1, 2, and 3. Enter here and n the Summary Page, Line 14.) TOTAL 9 FPPC Frm 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gv (866/ )