HomeMy WebLinkAboutItem 2 - Attachment 4 - Disclosure Statement f D e v e l 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 Division I Development Processing
Of
CHULAVbTA APPLICATION APPENDIX B
Disclosure Statement
Pursuant to City Council Policy 101-01, prior to any action on a matterthat requires discretionary action by the City
Council,Planning Commission or other official legislative body of the City,a statement of disclosure of certain
ownerships,financial interest,payments,and campaign contributions 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).
Sunroad Chula Vista Land,Inc.
2. If any person*identified In section 1.above is a corporation or partnership,list the names of all
individuals with an investment of$2000 or more in the business (corporation/partnership) entity.
Aaron Feldman
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3. If any person's 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, beneficiary
and trustor of the trust.
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4. Please identify every person, including any agents,employees,consultants,or independent
contractors, whom you have authorized to represent you before the City in this matter.
Craig Bachmann
5. Has any person *identified in 1., 2.,3.,or 4.,above,or otherwise associated with this 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
If yes,briefly describe the nature of the financial interest the official**may have in this contract,
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Form
4 of 9 320
276 Fourth Avenue I Chula Vista California I 91910 I (619) 691.5101 Rev 07,14
Attachrncnt 4
T D e v e l 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 Division I Development Processing
CHUU OF APPLICATION APPENDIX B
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 V' No
if yes which council member? Steve Padilla
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, money to retire a legal debt,gift, loan,
etc.) Yes No J
If yes,which official" and what was the nature of the item provided?
8. Has any person *identified in 1.,2.,3.,or 4.,above,or otherwise associated with this contract, project
or application,been a source of income of$500 or more to an official**of the City of Chula Vista in the E
past(12) months? Yes No__ €
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If yes,which official** and the nature of the item provided?
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Date
Signature of Contractor/Applicant
Dan Feldman
Print or type name of Contractor/Applicant
* Person is identified as:any individual,firm,co-partnership,joint venture,association,social club,
fraternal organization,corporation,estate,trust, receiver,syndicate, any other county,city, municipality,
district,or other political subdivision,or any other group or combination acting as a unit.
** official includes, but is not limited to; Mayor,Council member,Planning 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 time the project application,or contract, is submitted
to City staff for processing,and updated within one week prior to consideration by legislative body.
Last Updated: March 16,2010
Form
SON 320
276 Fourth Avenue I Chula Vista California 1 91910 1 [619] 691.5101 REV 07.14