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Home My WebLink About2019.01.29_Addis_Dawn_Form 460Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from Oct 21, 2018 Dec 31, 2018 through 1. Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee O State Candidate Election Committee O Recall (Also Complete Part 5) ❑ General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee ❑ Primarily Formed Ballot Measure Committee O Controlled O Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) Date of election if applicable: (Month, Day, Year) 11/6/2018 Date Stamp RECEIVED City of Morro Bay JAN 2 9 2019 City Clerk 2. Type of Statement: ❑ Preelection Statement • Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE Page 1 of 10 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report 3. Committee Information I.D. NUMBER 1406734 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Dawn Addis City Council STREET ADDRESS (NO P.O. BOX) CITY Morro Bay STATE ZIP CODE CA 93442 AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Treasurer(s) NAME OF TREASURER Gail Bunting MAILING ADDRESS CITY Morro Bay STATE ZIP CODE CA 93442 NAME OF ASSISTANT TREASURER, IF ANY AREA CODE/PHONE MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / 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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on Executed on Executed on Executed on Date Date 1- 2- - 1 9 Date Date r' `tached schedules is true and complete. I Signature of Controlling Officeholder, Candidate, State Measure Proponent 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 COVER PAGE - PART 2 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Dawn Addis OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member - Morro Bay, CA RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Morro Bay CA 93442 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 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 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 List names 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 Summary Page SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period from Oct 21, 2018 Dec 31, 2018 through Page SUMMARY PAGE 3 of 10 NAME OF FILER Dawn Addis City Council Contributions Received 1. Monetary Contributions 2. Loans Received 3. SUBTOTAL CASH CONTRIBUTIONS 4. Nonmonetary Contributions 5. TOTAL CONTRIBUTIONS RECEIVED Expenditures Made 6. Payments Made 7. Loans Made 8. SUBTOTAL CASH PAYMENTS 9. Accrued Expenses (Unpaid Bills) 10. Nonmonetary Adjustment 11. TOTAL EXPENDITURES MADE Current Cash Statement 12. Beginning Cash Balance 13. Cash Receipts 14. Miscellaneous Increases to Cash 15. Cash Payments 16. ENDING CASH BALANCE Schedule Al Line 3 $ Schedule B, Line 3 Add Lines 1 + 2 Schedule C, Line 3 Add Lines 3 + 4 $ Schedule E, Line 4 $ Schedule H, Line 3 Add Lines 6 + 7 $ Schedule F, Line 3 Schedule C, Line 3 Add Lines 8 + 9 + 10 $ Previous Summary Page, Line 16 Column A, Line 3 above Schedule 1, Line 4 Column A, Line 8 above Add Lines 12 + 13 + 14, then subtract Line 15 If this is a termination statement, Line 16 must be zero, 17. LOAN GUARANTEES RECEIVED 7,011.64 0 Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 3,356.00 0 Column B CALENDAR YEAR TOTAL TO DATE $ 18,409.00 0 $ 3,356.00 $ 18,409.00 5,439.48 6,266 48 8,795.48 $ 24,675.48 7,011.64 $ 0 5,439.48 12,451.12 $ $ 6,406.99 $ 3,356.00 0 7,011.64 2,751.35 Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ 15,661.65 0 15,661,65 0 6,266.48 21, 928.13 To calculate Column B, add amounts in Column A to 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 1406734 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions Received $ 21. Expenditures Made $ 1/1 through 6/30 7/1 to Date 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 *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 wnoie aouars. Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE Statement covers period from Oct 21, 2018 CALIFORNIA FORM Page 460 4 10 of through Dec 31, 2018 NAME OF FILER Dawn Addis City Council I.D. NUMBER 1406734 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR 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) 10/22/2018 John Ashbaugh San Luis Obispo, CA 93405 VI IND ❑ COM ❑ OTH Instructor Allen Hancock College 99.00 99.00 • PTY • SCC 10/26/2018 John Ashbaugh Luis Obispo, CA 93405 J IND Instructor Allen Hancock College 50.00 149.00 o�H •San • PTY ❑ SCC 10/28/2018 Gregory Martin Morro Bay CA 93442 ! IND Attorney James, Murphy Law 300.00 300.00 ■ COM El OTH • PTY ❑ SCC 10/28/2018 Kevin James Campbell SLO CA 93401 ZI IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Financial Advisor Northwestern Mutual 300.00 300.00 10/28/2018 Jane Heath 1052 Main St. Suite A Morro Bay CA 93442 tr1 I N O Attorney Law Offices of Jane Heath 25.00 128.00 M CoM ❑ OTH ❑ PTY • SCC SUBTOTAL $ 774.00 Schedule A Summary 1. 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. 3356.00 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL $ 3,019.00 337.00 *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 A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) MonetaryContributions Received to whole dollars. ononscovers Statement period from Oct 21, 2018 CALIFORNIA 460 FORM Page 5 of 10 through Dec 31, 2018 NAME OF FILER Dawn Addis City Council I.D. NUMBER 1406734 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR 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) 10/28/2018 Tierra Redonda,LLC 2206 Ronda Vista Dr. Los Angeles, CA 90027 ❑ IND ■ COM gi OTH ❑ PTY ■ SCC 1,000.00 1,000.00 10/28/2018 Teresa& William Szymczak Rolling Hills Estates CA90274 ® IND ❑CoM ❑ OTH ■ PTY ❑ SCC Self Employed Preservation Partners 1,000.00 1,000.00 10/29/2018 Megan Oglevie Portland OR 97220 ® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Sales Rep Full Circle Farms 20.00 100.00 11/9/2018 Martha Van Der Veer Johnson Morro Bay CA 93442 V IND ❑COM ■ OTH ❑ PTY ❑ SCC Homemaker 200.00 200.00 10/26/2018 Patricia Gordon Morro Bay, CA 93442 ® IND ❑ coM ❑ OTH ❑ PTY ❑ SCC Retired 25.00 125.00 SUBTOTAL $ 2245.00 *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 C Amounts may be rounded SCHEDULE C LU WHOM' UUIIitfb. Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE Statement from through covers period Oct 21, 2018 . CALIFORNIA Ann FORM Page 6 of 10 Dec 31, 2018 NAME OF FILER Dawn Addis City Council I.D. NUMBER 1406734 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) DESCRIPTION OF GOODS OR SERVICES AMOUNT/ FAIR MARKET VALUE CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 - DEC 31) PER ELECTION TO DATE (IF REQUIRED) 10/31/208 Dawn Beattie Morro Bay, CA 93442 None Office supplies,etc 314.00 469.00 !►'4 IND ■ COM ■ OTH ■ PTY ■ SCC 11 /11 /2018 April Elliott PO Box 835 Morro Bay CA 93443 April Elliott Designs Graphic Design 125.48 125.48 Ir4 IND ■ COM • OTH ❑ PTY • SCC 11/18/2018 Joe Birney Morro Bay CA 93442 IND Joe Birney Designs Graphic Design 1,000.00 1,000.00 ■ COM ❑ OTH ❑PTY ❑ SCC 11/7/2018 Travis Ford Morro Bay 93442 Ga IND 0 COM ❑ OTH ❑PTY ❑ SCC Rock Harbor Marketing Website 4,000.00 4,000.00 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 5,439.48 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.) $ 5,439.48 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.) $ 0.00 TOTAL $ 5,439.48 "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 Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Dawn Addis City Council Amounts may be rounded to whole dollars. Statement covers period from Oct 21, 2018 through Dec 31, 2018 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS CTB CVC FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB Page 7 I.D. NUMBER 1406734 SCHEDULE E of 10 radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration 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 USPS 848 Napa Ave Bay CA 93442 POS $864.72 Morro USPS 848 Napa Ave Bay CA 93442 POS $437.88 Morro Hay 3118 Morro Printing G Bay Main St CA 93442 LIT $902.95 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2205.55 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.) TOTAL $ FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov 6,251.59 760.05 0.00 7,011.64 Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period from Oct 21, 2018 through Dec 31, 2018 SCHEDULE E (CONT.) Page 8 of 10 NAME OF FILER Dawn Addis City Council I.D. NUMBER 1406734 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS CTB CVC FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration 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 New Times 1010 Marsh St SLO, CA 93401 PRT $405.00 Julie Sherrod Morro Bay CA 93442 POS 350.00 Rock Harbor Marketing 898 Napa #267 Morro Bay CA 93442 Social Media Boost 500.00 April Elliott Designs PO Box 835 Morro Bay CA 93443 LIT 125.48 Jen Ford Morro Bay CA 93442 Reimbursement, food for campaign party 912.46 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,292.94 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 Amounts may be rounded to whole dollars. Statement covers period from Oct 21, 2018 through Dec 31, 2018 SCHEDULE E (CONT.) Page 9 of 10 NAME OF FILER Dawn Addis City Council I.D. NUMBER 1406734 CODES: If one CMP CNS CTB CVC FIL FND IND LEG LIT of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration 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 Spencer's Market 2650 Main St. Morro Bay, CA 93442 Food for volunteers/ Election day 103.86 MB Chamber of Commerce 695 Harbor St Morro Bay, CA 93442 MTG Chamber Holiday Dinner 162.40 Joe Birney Morro Bay, CA LIT 500.00 La Parisienne 1140 Front St Morro Bay, CA 93442 Food for swearing in party 108.85 MBHS Jazz Band 235 Atascadero Rd Morro Bay, CA 93442 CVC 250.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1125.11 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 Amounts may be rounded to whole dollars. Statement covers period from Oct 21, 2018 through Dec 31, 2018 SCHEDULE E (CONT.) Page 10 10 of NAME OF FILER Dawn Addis City Council I.D. NUMBER 1406734 CODES: If one CMP CNS CTB CVC FIL FND IND LEG LIT of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings MBR member communications MTG meetings and appearances OFC office expenses PET petition circulating PHO phone banks POL polling and survey research POS postage, delivery and messenger services PRO professional services (legal, accounting) PRT print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration 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 Julie Sherrod Morro Bay CA 93442 Reimburse for campaign party food 127'99 Rock Harbor Marketing 898 Napa #267 Morro Bay CA 93442 WEB 500.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 627.99 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov