HomeMy WebLinkAboutItem 2 - Attch 3 - Disclosure StatementM
D e v e t o p m e n t S e. r it i c e s D e. p a r t m e n t
Planning Division l Development .Pro"cessi.ng
CANOF
(--FULA VISTA, APPLICATION APPENDIX
Disclosure Statement
Pursuantto CityCo.until Policy 101- 01,' prior : to any action on a matter tf atrequires discretionary:acti.on bythe City
Council, Planning:Com.miss on or other official legislative Body of the City, a statement of disclosure of certain
ownerships, financial interest, payments, and campaign coritribu:tlons must be filed. The following information must
be disclosed:
1. List the names of all persons having a financial interest in the project that is the subject of the
application; project or contract (e.g., owner, applicant, contractor, subcontractor, Material supplier).
_B.;A i3_vin & Sol,s t $
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2. If any person's identified in section 1. above is a corporation or partnership, list the names of all
in: clWidua.ls with an investment of $2000 o.r more in the business (corporation /partnership) entity,
Alfl'elllTVf7
3. If any person* identified in section 1. above is a non - profit organization or trust; list the names of
any person who is the director of the non- profit organization or the names of the trustee., b.enefir -lacy
and trustor of the trust.
4. Please identify every person; including any agents; eMployees, consultants, or independent
contractors, whom you have authwiized to represent you before the City in this matter.
Nick Lei
Maria Miller
S. Has any person *identified in 1:, 2., 1, or 4,; alcove, or: otherwise a.s.sociated with Oi:s contract, project
or application, had any financial dealings with an official ** of the City of Chula Vista as it relates to this
contract, project or application within the past 12 months? Yes No X
I.fyes, briefly describe the nature of the financial interest the official* may have in this contract:
409 V.Farm
276 Fnurth Avenue I Chula l/ista. � Cal,ifornia 9191(1 (6191691-5101 y�
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CITY OF
iULA WSTA
❑ e v e I o p m e n t S e r v i c e s. D :e p a r t m e n t
Planning Div.is'ion ( Devel.opm;ent. Processing
APPLICATION APPENDIX
Disclosure Statement - Page 2
6. Has any person *identified. in 1., 2.; 3;, or 4.;. above,; or otherwise associated. with this contract; project .
or:application, made a campaign contribution of more than $250 within the past (12) months. to a
current member of'.the :City of Chula Vista Council ? Yes x No
ifyes Which council m:e.mber? 1�;�t��,�_J= Alccaan..
7. Has any person *identified in 1., 2., 3., or 4., above, or otherwise associated with this contract, project
or application, provided more than $420 (or an item of equivalent value) to an official" of the City of
Chula Vista in the past (12) months? (This includes any payment that confers 'a personal benefit on the
recipient,-a. rebate or discount in.the price of anything of value, Morley to retire a legal debt, gift, loan,
etc.) Yes No _ _
If yes, which official** and what Was the nature of the item provided?
8. Has any person *identified in 3., 2., 3.,, or 4,, above; ox otherwise associated with this contract, project
or application, been a source .of income of $50:0 or more to an official" of the City of Chula Vista in the.
past.(12) rhonths? Yes No
x
If yes;. which official ** and the nature of the item provided?
*
Person is identified as; any individual, firm, co- partnership, joint venture, association; social club,
fraternal organization, corporation, estate, trust, receiver, syr+dicate, any other county, city, mull! pal
or other political subdivision, or any iitk4eJ group or combination acting as a unit,
official includes, but is not limited to; Mayer, Council member, Pianrving Commissioner, Member of a
board, commission or committee of the. City, and City employee or staff members.
* # This disclosure Statement must be completed at the timeth'e project application, or.contractJs submitted.
to City staff;for processing, and updated within one week pr'i:or to consideration :by legislative body;
Last:Updateci; March 16, 2010
M50f9 276; Fourth Avenue ! Chula Vista � California I 91'910 � (619) 5:91:,5101