Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period Date of election if applicable: Month, Day, Year) 11/ 6/ 18 Date Stamp keec- r V JAN 3120171 CITY CLERK COVER PAGE CALIFORNIA I FORM Page 1 12 of For Official Use Only 1. Type of Recipient Committee: All Committees Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee Q Recall 0 Controlled Also Complete Part 5) General Purpose Committee Sponsored Small Contributor Committee 0 Sponsored Also Complete Part 6) Political Party / Central Committee ( Also Complete Part 7) 3. Committee Information MITTEE NAME (OR CANDIDATE' S NAME IF NO MITTEE) Friends of Mike Harris for Mayor of Petaluma 2018 Primarily Formed Candidate/ Officeholder Committee 1361583 2. Type of Statement: Preelection Statement P Semi - annual Statement Termination Statement Also file a Form 410 Termination) Amendment ( Explain below) Treasurer(s) NAME OF TREASURER Mike Harris MAILING ADDRESS Quarterly Statement Special Odd -Year Report STREET ADDRESS ( NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE Petaluma CA 94952 MAILING ADDRESS ( IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE /PHONE Petaluma CA 94975 NAME OF ASSISTANT TREASURER, IF ANY N/ A MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE Petaluma CA 94975 OPTIONAL: FAX/ E -MAIL ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E- MAILADDRESS 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 penalty of perjury under the laws of the State of California that the foregoing is true and correct. ' ta n f\ 1 Executed on Executed on 1/ 30/ 17 Date 1/ 30/ 17 Date By By Executed on Date By Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on Date By Signature of Controlling Officeholder, Candidate, Stale 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 Page COVER PAGE - PART 2 a of fa 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Mike Harris OFFICE SOUGHT OR HELD ( INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) BALLOT NO. OR LETTER JURISDICTION SUPPORT Mayor of Petaluma 2018 OPPOSE RESIDENTIAUBUSINESS ADDRESS ( NO. AND STREET) CITY STATE ZIP Petaluma CA 94952 Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT 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. OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY MITTEE NAME NAME OF TREASURER MITTEE ADDRESS CONTROLLED MITTEE? YES NO STREETADDRESS ( NO P.O. BOX) 7. Primarily Formed Can Committee List names of officeholder(s) or candidates) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE CITY STATE ZIP CODE AREA CODE /PHONE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT MITTEE NAME NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD OPPOSE SUPPORT OPPOSE NAME OF TREASURER MITTEE ADDRESS CONTROLLED MITTEE? YES NO STREETADDRESS ( NO P.O. BOX) NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE CITY STATE ZIP CODE AREA CODEIPHONE Attach continuation sheets if necessary FPPC Advice: advice @fppc.ca. gov (866/ 275-3772) www.fppc. ca. gov
Campaign Disclosure Statement Summary Page Amounts may be rounded to whole dollars. Statement covers period SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE NAME OF FILER Friends of Mike Harris for Mayor of Petaluma 2018 Page I of 1361583 A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD CALENDAR YEAR FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 5, 850. 00 5, 850. 00 1. Monetary Contributions...... 0 0 1/ 1 6/ 30 7/ 1 to Date 2. Loans Received...... Schedule e, Line 3 5, 850.00 5, 850. 00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS... Add Lines 1 + 2 Received $ $ 0 0 4. Nonmonetary Contributions...... Schedule c, Line 3 21. Expenditures 5, 850.00 $ 5, 850.00 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED...... Add Lines 3 + 4 Expenditures Expenditures Made Made 6. Payments Made...... Schedule E, Line 4 $ 7. 7. Loans Loans Made Made...... Schedule Schedule H, H, Line Line 33 8. SUBTOTAL CASH PAYMENTS...... Add Add Lines Lines 66 + + 77 $ $ 9. Accrued Expenses ( Unpaid Bills)...... Schedule F Line 3 Schedule C, Line 3 10. 10. Nonmonetary Nonmonetary Adjustment Adjustment......... 11. TOTAL EXPENDITURES MADE...... Add Lines 8 + 9 + 10 $ 100. 00 $ 100. 100. 00 00 00 00 100. 100. 00 00 $ $ 100. 100. 00 00 00 00 00 0 100. 00 $ 100. 00 I $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* If Subject to Voluntary Expenditure Limit) Date of Election mm /dd /yy) Total to Date Current Cash Statement 12. Beginning Cash Balance... Previous Summary Page, Line 16 $ 1, 948.07 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 e, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents...... See instructions on reverse $ 19. Outstanding Debts... Add Line 2 + Line 9 in Column 8 above $ 5, 850. 00 0 100. 00 7, 698. 07 To calculate Column B, add amounts in Column A to the corresponding amounts Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts Lines 2, 7, and 9 ( if any). I $ Amounts in this section may be different amounts reported in Column B. FPPC Advice: advice @fppc.ca. gov (866/ 275-3772)
Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period SEE INSTRUCTIONS ON REVERSE l Page of NAME OF FILER Friends of Mike Harris for Mayor of Petaluma 2018 1361583 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IFAN IVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR IF MITTEE, ALSO ENTER ID NUMBER) OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE * IF SELF- EMPLOYED, ENTER NAME PERIOD JAN. 1 - DEC. 31) IF REQUIRED) 12/4/ 16 Don Smith O Retired Insurance Broker 150. 00 150. 00 12/ 26/ 16 South Petaluma Partners, LLC Emeryville, CA 94608 0 250. 00 250. 00 50 Refund sent Check# 1060 Anthy O' Brien 0 12/ 24/ 16 p o H CEO Top Speed Data 200. 00 200. 00 12/ 22/ 16 Patrick Connelly B El Retired 25.00 25.00 12/ 24/ 16 D. Edward Ricci O Kenwood, CA 95452 Retired 50. 00 50. 00 SUBTOTAL $ 675. 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.)... TOTAL $ 5, 850. 00 Q 5, 850. 00 Individual Recipient Committee other than or ) Other (e. g., business entity) Political Party Small Contributor Committee FPPC Advice: advice@fppc.ca. gov (866/ 275-3772)
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA ( CONT.) Monetary Contributions Received to whole dollars. Statement covers period 1A page of NAME OF FILER 1361583 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED IF MITTEE, ALSO ENTER ) CODE * IF AN IVIDUAL, ENTER OCCUPATION AND EMPLOYER IF SELF - EMPLOYED, ENTER NAME AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE PERIOD JAN. 1 - DEC. 31) IF REQUIRED) 12/ 22/ 16 Gary Imm Petaluma, A 94952 Retired 200. 00 200. 00 12/ 22/ 16 Judy Hillery la Retired 100. 00 100. 00 12/ 22/ 16 Susan Rapoza Bookkeeper Jerry's Refrigeration, Inc. 200. 00 200. 00 12/ 27/ 16 Law Office of John F. Lemmon Glen Ellen, CA 95442 Q 200. 00 200. 00 12/ 23/ 16 Richard Sharke 01ND com Retired 200. 00 200. 00 SUBTOTAL $ 900. 00 Individual Recipient Committee other than or ) Other (e.g., business entity) Political Party Small Contributor Committee FPPC Advice: advice @fppc.ca. gov (866/ 275-3772)
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA ( CONT.) monetary to whole dollars. LontnnutionS Keceiveci Statement covers period So' page NAME OF FILER V of 1361583 DATE RECEIVED FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF MITTEE, ALSO ENTER ) CONTRIBUTOR CODE * IFAN IVIDUAL, ENTER OCCUPATION AND EMPLOYER IF SELF - EMPLOYED, ENTER NAME AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE PERIOD JAN. 1 - DEC. 31) IF REQUIRED ) 12/ 23/ 16 Lucille Sharke NZ Retired 200. 00 200. 00 George Whitten 12/ 26/ 16 Machinist 200. 00 200. 00 0 USA, Inc. ScC Norman Reger la 12/ 27/ 16 Carolyn Strange Retired 100. 00 100. 00 Retired 100. 00 100. 00 Scott Montgomery la 12/ 27/ 16 President 200. 00 200. 00 0 PT, Montgomery Corporation SUBTOTAL $ 800. 00 Individual Recipient Committee other than or ) Other (e. g., business entity) Political Party Small Contributor Committee FPPC Advice: advice @fppc.ca. gov (866/ 275-3772)
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA ( CONT.) Monetary Contributions Received to whole dollars. statement covers period CALIFORNIA FORM 460 Page 1 of NAME OF FILER Friends of Mike Harris for Mayor of Petaluma 2018 1361583 IFAN IVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED IF MITTEE, ALSO ENTER ) CODE * IF SELF - EMPLOYED, ENTER NAME PERIOD JAN. 1 - DEC. 31) IF REQUIRED) Erin Montgomery 12/ 27/ 16 Housewife 200. 00 200. 00 Mahoney Davison Co. 100. 00 100. 00 Frederick Frost la Retired 25. 00 25. 00 12/28/ 16 Jack Overton El Contracting Self Jack Overton General 100. 00 100. 00 Michael Regan Ia Mortgage Banker Stearns Lending, LLC 200. 00 200. 00 SUBTOTAL $ 625. 00 Individual Recipient Committee other than or ) Other (e. g., business entity) Political Party Small Contributor Committee FPPC Advice: advice @fppc. ca. gov (866/ 275-3772)
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE ( CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIAA FORM 60 Page u of NAME OF FILER Friends of Mike Harris for Mayor of Petaluma 2018 1361583 IF AN IVIDUAL, ENTER DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED IF MITTEE, ALSO ENTER ) CODE * IF SELF - EMPLOYED, ENTER NAME AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE PERIOD JAN. 1 - DEC. 31) IF REQUIRED) Patricia Regan OT Mortgage Advisor The Regan Team Home 200. 00 200.00 Loan Group Redwood Building Maintenance Co., Inc. B 50. 00 50.00 Jerry & Don' s Yager Pump & Well 100. 00 100. 00 Mike Haire com Retired 50. 00 50. 00 Dan Reed O Owner Reed' s Trailer 200. 00 200.00 SUBTOTAL $ 600. 00 Individual Recipient Committee other than or ) Other (e. g., business entity) Political Party Small Contributor Committee FPPC Advice: advice @fppc. ca. gov (866/ 275-3772) www.fppc. ca. gov
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE ( CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA FORM 460 Page of ( NAME OF FILER Friends of Mike Harris for Mayor of Petaluma 2018 1361583 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR CODE "` RECEIVED IF MITTEE, ALSO ENTER ) IF AN IVIDUAL, ENTER OCCUPATION AND EMPLOYER IF SELF - EMPLOYED, ENTER NAME AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED THIS CALENDAR YEAR TO DATE PERIOD JAN. 1 - DEC. 31) IF REQUIRED) Ann Reed is Housewife 200. 00 200. 00 12/ 22/ 16 Don' s Garage Door Company 0 200. 00 200. 00 Pierre Miremont CEO Architectural Plastics 100. 00 100. 00 LCRD David Albaugh, Sr. p Instructional Designer Coast Guard Training 100. 00 100. 00 Rohnert Park, CA 94928 Center - Petaluma El PT, Scc Lynn Fazio O HR Director Autodesk 200. 00 200. 00 SUBTOTAL $ 800. 00 Individual Recipient Committee other than or ) Other (e. g., business entity) Political Party Small Contributor Committee FPPC Form 460 (Jan / 2016) FPPC Advice: advice @fppc.ca. gov (866/ 275-3772)
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA ( CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA, ' Eac,. lb of ' NAME OF FILER Friends of Mike Harris for Mayor of Petaluma 2018 1361583 IF AN IVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED IF MITTEE, ALSO ENTER ) CODE IF SELF- EMPLOYED, ENTER NAME PERIOD JAN. 1 - DEC. 31) IF REQUIRED) Joseph Sturla Vice President Affinity Marketing 200. 00 200. 00 Term Care El Resources 12/ 30/ 16 Christopher Krive com Retired 75. 00 75. 00 12/ 30/ 16 C. Jane Brown com El Retired 200. 00 200. 00 Willie McDevitt Q President com McDevitt Construction 200. 00 200. 00 12/ 30/ 16 Barbara Howey San Rafael, CA 94903 O com Retired 100. 00 100. 00 SUBTOTAL $ 775. 00 Individual Recipient Committee other than or ) Other (e. g., business entity) Political Party Small Contributor Committee FPPC Advice: advice @fppc.ca. gov (866/ 275-3772)
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULEA ( CONT.) Monetary Contributions Received to whole dollars. Statement covers period Page ' of NAME OF FILER Friends of Mike Harris for Mayor of Petaluma 2018 1361583 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR RECEIVED IF MITTEE, ALSO ENTER ) CODE IFAN IVIDUAL, ENTER OCCUPATION AND EMPLOYER IF SELF - EMPLOYED, ENTER NAME AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE PERIOD JAN. 1 - DEC. 31) IF REQUIRED) Robert Spurgeon Owner Spurgeon Painting 100. 00 100. 00 Ray Nizibian D. D. S. PT, Dentist Retired 100. 00 100. 00 scc 12/ 30/ 16 12/ 30/ 16 Gregory Tracey la Retired Law Enforcement 75. 00 75. 00 Don Ramatici Q Insurance Broker Don Ramatici Insurance 200. 00 200. 00 Mary Farrar 01ND 0 Placement Specialist Senior Placement 200. 00 200. 00 SUBTOTAL $ 675. 00 Individual Recipient Committee other than or ) Other (e.g., business entity) Political Party Small Contributor Committee FPPC Form 460 (! an /2016) FPPC Advice: advice @fppc. ca. gov (866/ 275-3772)
Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period SCHEDULE E SEE INSTRUCTIONS ON REVERSE NAME OF FILER Page ( a of t a Friends of Mike Harris for Mayor of Petaluma 2018 1361583 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 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 MITTEE, ALSO ENTER ) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID South Petaluma Partners, LLC Emeryville, CA 94608 RFD Refunded excess campaign contribution 50.00 Secretary of State Sacramento, CA 95814 Fil I Annual Fee for open campaign account IM Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 100.00 Schedule E Summary 1. Itemized payments made this period. ( Include all Schedule E subtotals.)...... $ 100. 00 2. Unitemized payments made this period of under $ 100...... $ 3. Total interest paid this period on loans. ( Enter amount 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.)... TOTAL $ 100. 00 FPPC Form 460 (Jan / 2016) FPPC Advice: advice@fppc.ca. gov (866/ 275-3772)