CAMPAIGN FINANCING DISCLOSURE STATEMENT FOR THE 2011 GENERAL ELECTION (COUNCILLOR) SUMMARY OF CAMPAIGN CONTRIBUTIONS SUMMARY OF ELECTION EXPENSES

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1 Local Government Act Section 90 CITY OF NANAIMO CAMPAIGN FINANCING DISCLOSURE STATEMENT FOR THE 2011 GENERAL ELECTION (COUNCILLOR) This disclosure statement is to be filed with the Manager of Legislative Services of the City of Nanaimo within 120 days after the local general election voting day (March 19, 2012). Disclosure statements may be filed from March 20 1 h, 2012 until Apri/18 1 h, 2012 on payment of a 500 late filing penalty to the City of Nanaimo. NAMEOFCANDIDATE: ~~~B_\~L_L~-~-c-~~~-~~~~~~~~~~~~~- NAME OF OFFICE for which the candidate sought election: -----=C-=O:...::U:...:.N.:...:C=I=L=LO=..:...:R' NAME OF ENDORSING ELECTOR ORGANIZATION (if applicable): SUMMARY OF CAMPAIGN CONTRIBUTIONS Total amount of campaign contributions 3\-:t-2 Total of (A, B & C) from Schedule A: Part 1 (page 4) List of contributors who made contributions totalling 100 or more Complete Schedule A: Part 2 (page 5) Total amount of anonymous campaign contributions remitted to the City of Nanaimo Total from Schedule A: Part 3 (page 6)..e: SUMMARY OF ELECTION EXPENSES Total amount of election expenses COMPLETE SCHEDULE B (page 7) SURPLUS FUNDS Transfer from local government (surplus funds from previous election) Balance (positive or negative) remaining in candidate's campaign account COMPLETE SCHEDULE C (page 8) CAMPAIGN ACCOUNT INFORMATION All monetary contributions were deposited in, and all election expenses paid from an account opened forthispurposeat Co06± c~ A-"\ Sa.\l.lC\~S locatedat "3<>o-~61 Avl"s ~d, t.l g, na.~ mo Rc (name of financial institution) (Branch address) NOTE: This is not a balance sheet. For example, contributions may not equal expenses. COMPLETE THE APPROPRIATE DECLARATIONS ON PAGES 2 AND 3 Page 1 of 13

2 DECLARATION OF CANDIDATE I, B \LL Me \cca'(, a candidate for COUNCILLOR in the City of Nanaimo election, solemnly affirm that to the best of my knowledge, information and belief: (a) (b) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act in relation to my election campaign for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo; and the requirements of Division 8- Campaign Financing of the Local Government Act have been met in relation to my election campaign for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo. Declared before me at ~ )a~ yvr..j this 16..fY\.. day of ~, British Columbia, 201a.. nt Officer or idavits for British Columbia DECLARATION OF ELECTOR ORGANIZATION OFFICIAL (it applicable) I,------~~ ' being the-----, ,-...,..,----- (title of authorized official) for the '~--:--:---, ,.,.,.----, ' solemnly affirm that to the (n e of elector organization) best of my knowledge, informa n and belief: (a) this campaign financing d1 Josure statement and supporting schedules completely and accurately discloses the infor' tion required by Section 90 of the Local Government Act for the election campaign of----~ ,.---:-----::-:-:-: (name of candidate) for the office of COUNCILLOR in the 2011 I,, I general election for the City of Nanaimo; and (b) the requirements of Division 8- Campaign Financ1 of the Local Government Act have been met in relation to the election campaign of-----~ for the office of COUNCILLOR in the 2011 local general el ion for the City of Nanaimo. Declared before me at, British Columbia this day of, 201_. Designated Local Government Officer or Commissioner for taking affidavits for British Columbia Signature of Elector Organization Official Page 2 of 13

3 DECLARATION OF CAMPAIGN ORGANIZER (ifappticabte) I, -~-- :~ ' being the-----::-::-:----:----:----:----:--:::-.,...,---- (title of authorized official) for the,..., :-:-----:-----:----:---: ' solemnly affirm that to the arne of elector organization) best of my knowledge, infor ion and belief: (a) this campaign financing closure statement and supporting schedules completely and accurately discloses the info ation required by Section 90 of the Local Government Act for the election campaign of----~, , (name of candidate) for the office of COUNCILLOR in the 2011 lo general election for the City of Nanaimo; and (b) the requirements of Division 8- Campaign Financin met in relation to the election campaign of------""""""'= for the office of COUNCILLOR in the 2011 local general elect1 Declared before me at------~---' British Columbia this day of ' 201_. Designated Local Government Officer or Commissioner for taking affidavits for British Columbia Signature of Campaign Organizer DECLARATION OF FINANCIAL AGENT 1 ' ----~o~b~e~w~~ ~~U~L=~~ 'havepffipaffidthis disclosure statement and su ppo rti ng schedules for -.,.,...,.=B:...:,. \ L-'L:::.,-...,...--M_c....:: 'l:...:.a...:.,.'( :-L-----,-----,-..,.,-,.,..~name of candidate (or elector organization or campaign organizer, if applicable) and solemnly affirm that to the best of my knowledge, information and belief that: (a) (b) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act in relation to the election campaign of S\LL tv\ '- \(A 1 (name of can idate) for COUNCILLOR in the 2011 local general election for the City of Nanaimo; and the requirements of Division 8 - Campaign Financing of the Local Government Act have been met in relation to the election campaign of E:, """- ''-" '--=L---'-t'\...!...:... c _,\L~A'-'{-1--:--.,..,..,--..., (name of candidate) for COUNCILLOR in the 2011 local general election for the City of Nanaimo. --+~...::>,A~N.:...=...,.u""'--:'-+}YD_,.""--'-- _.!_~-=.;::... ::-= ~. British Columbia Page 3 of 13

4 CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS SCHEDULE 'A' PART 1: CONTRIBUTIONS Contributions from known sources Total value of contributions of 100 or more from a single source (A) 2615 Unless nil, complete Schedule A: Part 2 (page 5). Total value of contributions totalling or less from a single source {B) : Contributions from anonymous sources Contributions from anonymous sources LESS: value of anonymous contributions over 50 remitted to the City of Nanaimo (Total from Schedule A: Part 3- page 6) Total value of anonymous campaign contributions of 50 or less =(C) TOTAL VALUE OF CONTRIBUTIONS (A+ B +C)= 3\1-2- Total number of contributors who made contributions totalling or less 3 Page 4 of 13

5 CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS SCHEDULE 'A' PART 2: LIST OF CONTRIBUTORS TOTALLING 100 OR MORE from Item (A) (page 4) * 1 * FULL NAME z ADDRESS DATE AMOUNT (if applicable) * 3 * CLASS SEE _kr 1 Ac\-\ED S-.J MWI~N TOTAL Attach supplementary list 1f required *1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members. *2* Do not report addresses of individuals. *3* Classes: individual, corporation, unincorporated organization, trade union, non-profit organization, other. Page 5 of 13

6 CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS SCHEDULE "A" PART 2: LIST OF CONTRIBUTIONS TOTALING 100 OR MORE FULL NAME ADDRESS DATE AMOUNT CLASS J. Goldsack 09/11/2011 Manjet Bal 09/11/2011 Georgia View Village JV 08/11/ BC Ltd. ( Directors: Dave Francis & Dave Hammond) Sunglo Lumber Ltd Applecross Rd., Nanaimo BC Alberta Inc Macleod Trail SW 16/11/2011 (Dir. G. Brower) Calgary, AB Nored Development Inc. # Applecross Rd., Nanaimo BC 08/11/2011 Newcastle Engineering Ltd. # Barons Road, Nanaimo, BC 09/11/2011 Williamson & Associates Professional Surveyors 09/11/2011 Williamson Land Surveying Inc 3088 Barons Road, Nanaimo, BC Henning Land Surveyoing Inc Barons Road, Nanaimo, BC Lewkowich Eng. Associates Ltd. A-2569 Kenworth Rd, Nanaimo, BC 10/11/2011 Del Silverthorne 10/11/2011 Greg Bullock 09/11/2011 Kwik Kopy Ltd Willgress Road, Nanaimo 18/11/ lndiv. 100 lndiv. 475 Corp. Corp. 500 Corp 500 Corp. 100 Corp. 100 Corp. Corp. 150 Corp. 250 lndiv. 300 lndiv. 300 Corp. TOTAL 2,875

7 CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS SCHEDULE 'A' PART 3- LIST OF ANONYMOUS CONTRIBUTIONS OVER 50 REMITTED TO CITY OF NANAIMO DATE VALUE DATE VALUE SUB-TOTAL -e SUB-TOTAL t7- GRAND TOTAL N\L Page 6 of 13

8 Local Government Act Section 90(4)(f) BC. Reg. 380/93 CAMPAIGN FINANCING DISCLOSURE STATEMENT SCHEDULE '8' ELECTION EXPENSE DETAILS A. Election campaign advertising or communication expenses for: (1) radio, television, newspaper, magazine or electronic advertising for the public (2) signs, pamphlets, flyers and brochures (3) advertising and promotion for the public not included in A(1) or (2) above (4) newsletters for members of the elector organization 3\4-1- B. Election campaign office expenses for: (1) compensation paid to persons for campaign work, other than for services described in Section 89(2) of the Local Government Act (2) rent, insurance and utilities (3) courier services and postage (4) furniture, telecommunication equipment and other equipment (5) office supplies and other office expenses not covered by 8(1) to (4) above C. Convention and similar meeting expenses D. Expenses for campaign related functions not described in C above E. Research and polling expenses F. Campaign related transportation,,ss G. Other expenses (provide description) Total amount of other expenses TOTAL AMOUNT OF ELECTION EXPENSES Page 7 of 13

9 Local Government Act Section 90(4) CAMPAIGN FINANCING DISCLOSURE STATEMENT SCHEDULE 'C' DETAILS OF SURPLUS FUNDS DISBURSEMENT A. B. C. Balance remaining in account Amount reimbursed to candidate from campaign account for the candidate's contributions to his/her campaign Amount of remaining surplus funds (after any reimbursement under B.) 135lf D. Details of the disbursement of remaining surplus funds under C. Page 8 of 13

10 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF CASH CAMPAIGN CONTRIBUTIONS * 1 * FULL NAME z ADDRESS DATE AMOUNT *J* CLASS (if applicable) TOTAL *1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members. *2* Do not report addresses of individuals. *3* Classes: individual, corporation, unincorporated organization, trade union, non-profit organization, other. Page 9 of 13

11 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF IN-KIND CAMPAIGN CONTRIBUTIONS * 1 *NAME * 2 * ADDRESS DATE GOOD or VALUE (if applicable) SERVICE "2.21"'1- w~t~ re~s "'Roacl N O.f\ O.IIMQ BC. \(w\~ \(o f>-1 LTD. Nov. I~(\ l Pr:i)~;~G 3oo- I TOTAL 3oo - *1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members. *2* Do not report addresses of individuals. Page 10 of 13

12 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF DISCOUNTED GOODS AND SERVICES GOOD OR SERVICE PRICE PAID FAIR MARKET VALUE (RETAIL VALUE) TOTAL ('JIL. Page 11 of 13

13 CAMPAIGN FINANCING RECORD KEEPING FORM CAMPAIGN CONTRIBUTIONS RECORD OF ANONYMOUS CAMPAIGN CONTRIBUTIONS 50 OR LESS CONTRIBUTION VALUE/AMOUNT DATE REMITTED TO LOCAL (MONEY, GOODS) (if greater than 50) GOVERNMENT TOTAL N\l- Page 12 of 13

14 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF ELECTION EXPENSES GOODS, PROPERTY OR SERVICES DATE DATE AMOUNT RECEIVED INCURRED PAID Siqns Nov. \'t I I ( Nov. I~ I " \Gf\5 No~. I~ { \\ NotJ. 3J l \I 5ott -..., l~n \Jo\uriteer M<Z~\s Noll~w- 1 2<> \1 Nove~ 1 \\ 1' g~ - Pr ~ '"'+~ (\ q NoV. 16\ II \n \L,"nJ. 3oo -...J TOTAL 32t6e.s- Page 13 of 13

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