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HomeMy WebLinkAboutItem 1 - Attachment 4- Disclosure ,:: - e y 1 m e n t `e r c e b p r t m: e .n ti ..�.:. - " planring Division 1 +� iil'ie_ , _....::.::: - t is;t�''c . . C '.i ... % ......... . . ess 1. . . . ... ...:.:. ....._ CHU�A IATA % �4PP� i ATrD�1 A�, .. C .: - . DJ tc i u r ,. t t frr; rpt . .. .::...: . .. P:....fiu rr :t ..:.;:..: -err, a"# �€ty couno(611 1Q1r01, for to an ac#ian.,o CY n a 1 matter. Y .. . heat rep. ires'�Iscefiortarj�a ►`i�y:t : ::G... auril :li� rin Commi3sion or a#her atFicial! Isiative:bad`'nft ;1 a 9 e9 ] G 1y, statenefatof disclosur+ '5certain -: ivrnetii``s-fnariciai interest s p , ?�Kri�ont ,an' campaign conte is iti[ i 'A 'ust o fled'=rhe, tr IQ 1�4$- I.o" . t..1 wing 1rfl�o-%%.: on`must , 1. ..: ....: st t e names of ail persons having a�,ri hCia1 i:rti crest It the ro eet ali t Is the s l ect poi?the ;' . ;..%p: . cation;; roject or contract e. aiiirheC a licant co . .:.. ... .....: :........,;.: 1. . P ,.. ,pp , ntractor,subcontradar:R.at -t' su lie� . . '.:- ..... .... ... . ... . -- ..:. ..:: . .....:.......... .. . ...". .,....... . ....:. . . .. .. .:..... . -::. ............ _ ...... - z: 1 ar�y rson�identified in sectioh 1,labvve Is a corporatiah of'patio rsl�ip,Hathe na�reab--a--" of .::__ [ dividuaEs:W1th an invextme ovr7D ar more Eri:the`buxins s[corporatlonlpartnershipyy` ``� ... . .... �. r• .... ...... . ,. .. . . M ... ., ;' .. it _ - ...... .. ��' ... :.:..::.� :- ..:.-. . .. .:. .�S..;i„ rim. ... .. ... .......y.:' .. ..r .:':.. .'.: _ -,..raersor+ eh n an , e s non-pr+a rt or+ganirati r�Ot trust;list t '+ 'r►ames . ah Y : Ines fife truttee,beneficiair- y Pers.lvw is the r ctor o1 the Ston-prat organi2atidon or t. a iia- atd trustor ofter<rtist: .... �t . .. ......::.. ::. 11. x .... . - 9 I ..-...:. _ .. . - .. .... ... ... .. ... .. .. ...r's. .. ...... .. ..... ...4.. ..-. ...... .... .. ... "-} a :. . -.. ....—. .:..:.. .. .. .u...... ..'.:.a ,,:!: C % �..:..[.es.., :. . .. " .. _ ... .. .. .. .."..-. - - -m. .. .,: " ......:.:.v.: aF... .: .:. .. ..... ..-. .. - ... .i..:..::.. rr'-� �isr.�"... -. 's::. r. f PI" S ea it1..IW; . , -. :ta':.indudir�. n : erttS i�rn`:lo e�es`:i dr�suitdn F itrd' ' :: :;:;::;; .: g Y g p . Y $1 .ems . .... r `.S -.:.... .:'... w otmors,=vhMT i)wave auti�vrized:tQ:re ►went op�efo� the �h tF13S'1�atlf �C >::; ;:: ;. s p � ..." .a �' ur : ... _ . - _ . . . .. ,±y_,y4�.rwrw [ .:!. ... - .. ..: - .. .. ".. _ .l�F"hI. �JY as. -": tifled:l a•.!'i .'.:: ...:�.'::, ►!1'Vt � 'P i?V�:T+t��4 We�i�'� i. /114�F14!�,::. V :_.,,. . A...y:: .. ..:;.::d::': :.... w�,; .�—. r fir,..... , .. . . . 1. ora iiiatio,il< eid: t1' iriart+clal' lir with an official"'vftlie Citi►of Ehhla Vistaas iit' latea<° is' pp r r lca ion .'.sthln;h ,Y:;:o si 1 enths7 �es:' ; : ;. No ; . : �Ontra�t,pr+ojec ebb i- 1.... t.,�P ," - ---,.. - . . ,� ., .,s _ .. . . ,,— .... - % .. . . .. . . h" .. .. .............. ...- '��r+ -..-i... - .. - ..::: .. . ... .....-... 1. . _ .. _ z: .,. .. .. .. .. if; esu isrl de� �lhre ti a ria ulE pf°tlt0-,:financiel•4t to e&t: e ± �i1 .trt Y ' �retn els��rrtt—- . rx .... . 400 276 Fourth 04"(1.0 I .+ChulA Vista .I (0.1.00 his.....I... .00-1 Q I im q):G91.. 'i Attachment 4 . - . .. . ..sz�kw ( . ...,. ". : .-, v e e. fa m : t n 5 e, r --.. D ; r t :m':e n . 4..,. . . - ,4 R'i.a `n:.rzg.:Ll.i:yisiors .� ,'a; :vela. .m.e:nt P�r:o'cessin .. . ..:. , .. .. .... . . . CTrY.c7F' . . . V >. ,..', ."ISA %% %A R S% �7.T.I�D i APR ND1] B . :.. ... , : . : . .; . OiGI sure t t : " ' :: .. _ .^. % o ^ ment 'a e.z . ;,_:. . . .-. . - . . 1� s' r n i . ... . :::.:: a a. y 1. so ...de-tied:in 1..H° .," ,.or 4, abaVe; w o#hervrrise as iatei�r+vith th bntratt, o ect "' . . ... % . i� I a �lioatlain a . a m de a caro ai n cvntrilut on of . P# P . 9 [.... ... ...t %, re than:5.25D.within:the:pa ::1 .rr►p tith5 to a .:. .current member of tha.Cit of Chula.Vista auneil Yes Y Na No. `-z . . ...:if high courrl`rititin�er?; . Vii;# w --. . . . .. ;. . ..: , . : ;;_ H n ..1.4 .. .as an rso identified in t,n�..3.=ar 4, above or ntherwis `'s'' i ed , . . Y pe aw.,..tt�art with this' t�tra�t;project' . % 777 . . . : .r a licati(in,provided more'than,,470[or an ite eiquivaf iep 'y4lile)s ari offitlal ;;of the C[ of ; =' PP tY. Chula:Yista intha past.(1y nibnths? phis intlrrd any payment ttlatiners,a;pernl:fbnefitan the reci iert a rebate or di ounC:I the rice.of:a hire of value,mune to:0.1re !: . al deb .. %.... P P 9 Y ..a9 t,grit,loan, .. ett.1 'des Np ,. .... ., ;...: . ,. . :,_: If e ,►iuhith o1`ticial and ry't was the nature of the item rnvided? :: ,. % ::: . ; ;;; ;': y , . p . _, :: . ., :: .. . ... .... . .. . . ,.. �.... ....4 - a� 1 , . -- ... — ,, -- a . ..-.. .. .. � ..:: :. . .. .. - .. _ • _. ^ <, r 3. i H anypersarr'idgntified in 1., :,3.,ar 4.,at�ove,.or otherwise assaclia��d��h this tantrac:.project . :.: _.._`:.0r a ca on,.:. satrrire of inEbMe of 55 i�rrnvre tp ar:oflicia .:i f the C pf'Ghuia Ysta#n thAN i e at. ;z months des ilio ..:....,... :: , -. if t s,which afi~iciai and tl�e'ha ire of the item provided = :.,- . .:. .. . :- ,,Y - - ;;z. - .. ... ... .... ... . _..... .. Vis:': .. :- . ... .. ;. ,. , ,_.:, x T. . ;. ...... ..:...:.... _ . . _. ;:... , . .... Z:- •.�y.:..-.-: hil " . . :' . H. 7. .:......... .......... ...... .. .. . .,..-.::::...,... ..: .... . . ... t <. t or- lica.. ^ . '�i-ri�iture of ion tart iRP . . � :. n r., ^ ^. . . .. Print or type rrarit+of[oniractorfApplicant, c F .. ....'. .: .. .. - .. . . .•:. ... .. ::. e .. .:.: :.:. r . .. .. .r� .r.' F.;: q r ._tip. .. 1 e.:. .:..:r. i::.. .,..., :.. iatiar� St itiai'elcib'' .__:�: °:,;.::'.;.'::::, 9 i er �►, i-.. .- -e;.any indi, U0, rm,:co-part�rtersfaip.;oint ventu e, sac .: . , g . . ... fraterti i.or i- on,.-rorpotation,.+eL.stateArust,receiver,syndicate,:eny other county;city,mu�icip.. i�A .. n in asau tt Irl%0r��e polltital ufbdi►c i hj- any other g ..p arjcom....lna1.tian. :< x:,;:,: ;:.':. `i ion` <; ' — Inn irti[r<.ss .. .. . .. ar'`C' tN rrrember P a irr1:4, „' arffiilial;�ntluid�' w.ts:npt:ihyi t A'°M: , aura , 9 ? ., eF,. . :.. .. r ff rs,,.. .. .:..:. . ..:.. d•Cbie►M s;il t�'. eo�mittee�ri�the Ci' ,.and�, ern a xta i e ! , ... .; "t i % . - PbY1. .. .. % i. *' This. isc. :I#" -..:t trttiiit_ c.:M .1.'ted ai the boli;;::the o ect a#rplioation'.0r�rontract, s seism.tted`- ` �# . . .. a nt. . : .�? .. ..Pe e t7 l ilia ` tity st ` S+t prtsiirtg:aMti `urp+ <rithine`iii itr to onsid ra op by ! 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