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Yes on L1 460Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period 10/23/16 from 12/31/16 through _ 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ® Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall O Controlled (Also Ccmplefe Part 5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored O Small Contributor Committee O Political Party /Central Committee ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part D 3. Committee Information 1139626 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) One Alamedan for Mediation (Enforceable) Yes on L1 STREET ADDRESS (NO P.O. BOX) 2031 Alameda Avenue CITY STATE ZIP CODE AREA CODE /PHONE Alameda CA 94501 (510) 865 -7369 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX P.O. Box 1343 CA 91501 CITY STATE ZIP CODE AREACODE /PHONE Alameda CA 94501 same OPTIONAL: FAX /E- MAILADDRESS 4. verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my certify under penalty of perjury under the laws of the State of California that the foregoing is true and 01/31/17 Ex,cuted on _ By Date Date of election if applicable: (Month, Day, Year) 11/08/16 COVER PAGE JAN Pag of 6 3 �, 291-1 i For Official Use Only CITY OF !- "LA 1DA 2. Type of Statement: ❑ Preelection Statement ® Semi - annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Jeff Cambra MAILING ADDRESS P.O. Box 1343 CITY STATE 'LIP CODE AREA CODE /PHONE Alameda CA 94501 (510)865 -7369 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX / E -MAIL ADDRESS or ned herein and in the attached schedules is true and complete. I Executed on _ By r/ Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on _ By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on _ By Date Signature of Controlling Cxficeholde r, 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 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE) RESIDENTIAL/BUSINESSADDRESS (NO.ANDSTREET) CITY STATE ZIP 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. NAME OF TREASURER COMMITTIE ADDRESS I.D. NUMBER I ❑ YES ❑ NO P.O. BOX) CITY STATE ZIP CODE AREACODE /PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTI'_EADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COVER PAGE - PART 2 Page 2 of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE The Rent Stabilization Act BALLOT NO. OR LETTER JURISDICTION ® SUPPORT L1 City of Alameda ❑ 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 Ustriames of officeholder(s) or candidates) for which this committee is primarily formed. NAME OF OF OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OF OR CANDIDATE OFFICE :,OUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OF OR CANDIDATE OFFICE :,OUGHT 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 Amounts may be rounded To calculate Column B, SUMMARY PAGE Summary Page 0 to whole dollars. Statement covers period � of your last report. Some 0 amounts in Column A may be negative figures that 10/23/16 � • 1 previous period amounts. If this is the first report being from filed for this calendar year, • - only carry over the amounts from Lines 2, 7, and 9 (if In any). 12/31/16 3 SEE INSTRUCTIONS ON REVERSE through Page _ of NAME OF FILER I.D. NUMBER 1391626 Contributions Received Column A THIS Column B Calendar Year Summary for Candidates TOTAL PERIOD (FROM ATTACHED EvCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and $2313 $4415 General Elections 1. Monetary Contributions .................... ............................... Schedule A, Line 3 $ $ 111 through 6/30 7/1 to Date 2. Loans Received ................................. ............................... Schedule e, Line 3 -$23'3- Jr 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 �- 2 $ $ Received $ $ — 4. Nonmonetary Contributions ............. ............................... schedule C, Lino 3 _ 21. Expenditures 2313 Made $ $ 5. TOTAL CONTRIBUTIONS RECEIVED ........ ............................Add Lines 3,- 4 $ $ Expenditures Made 6. Payments Made .............................. 7. Loans Made ...... ............................... 8. SUBTOTAL CASH PAYMENTS... 9. Accrued Expenses (Unpaid Bills) 10. Nonmonetary Adjustment ............... 11. TOTAL EXPENDITURES MADE. Schedule E, Lime 4 $ ............................... Schedule H, Lino 3 .............. I..................... Add Lines 6 ,- 7 $ ........ ............................... Schedule F, Lime 3 ....... ............................... Schedule C, Lime 3 .... ............................... Add Lines 6 + 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 13. Cash Receipts ............................ ............................... Column A, Line 3 above 14. Miscellaneous Increases to Cash ... ............................... Schedule 1, Lim, 4 15. Cash Payments .......................... ............................... Column A, Line 6above 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 8, Part $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................ ............................... See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 91n Column 8 above $ $2313 $ _ $4415 $2313 $ $2313 $ $4415 $4415 0 0 To calculate Column B, add amounts in Column 0 A to the corresponding amounts from Column B 0 of your last report. Some 0 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 In any). I Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" (if Subject to Voluntary Expenditore Limit) Date of Election Total to Date (mm /ddtyy) �L $ _ I -L $ *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 SChP_r'i111c, A Amounts may be rounded SCHEDULE A Monetary Contributions Received townoleconars. Statement covers periodIIIIIIIIIIIIIIIIIIIIIIIIII CALIFORNIA I �. 10/23/16 • from _ 12/31/16 through _ Page _ of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER 1391626 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PE: ELECTION TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN.1 -DEC. 31) (11: REQUIRED) OF BUSINESS) Jeff Cambra 16 IND Self Employed 11/17/16 2031 Alameda Ave. ❑ COM Festival Productions $2313 $4415 Alameda, Ca 94501 ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY El SCC SUBTOTAL $ 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. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ......................TOTAL $ (32313 0 $2313 "Contributor Codes IND — Individual COM — Recipient Committee (other than P'TY or SCC) OTH — Other (e.g., business entity) PTY — Political Parry SCC — Small Contributor Committee FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) vvww.fppc.ca.gov Schedule A (Continuation Sheet) Monetary Contributions Received Amounts may be rounded SCHEDULEA (CONT) to whole dollars. Statement covers periold-4-IIIIIIIIIIIIIIIIIIII CALIFORNIA from 10/23/16 FORM • r 'Contributor 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 (1an/2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov IC /JI /Ip (�1' through — Page _ of NAME OF FILER I.D. NUMBER 1391626 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR COMMITTEE, ALSO ENTER CONTRIBUTOR CODE * ]FAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENQAR YEAR PER ELECTION TO DATE RECEIVED (IF I.D. NUMBER) (IF SELF - EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Alameda Sun ❑ IND 11/17/16 ❑ CoM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑SCC SUBTOTAL $ 'Contributor 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 (1an/2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Schedule D SCHEDULE D bummary OT tX enaitures Amounts may be rounded p Statement covers period to whole dollars . Supporting /Opposing Other 10/23/16 - • Candidates, Measures and Committees from • 12/31/16 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER 1391626 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REWIRED) PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OR COMMITTEE Measure L1 ❑ Monetary Alameda Sun 11/17/16 City of Alameda Contribution Newspaper ad $2313 $4415 ❑ Nonmonetary Contribution ® Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ........................ ............................... $ 2. Unitemized contributions and independent expenditures made this period of under $ 100 ..................................................... ............................... $ $2313 I 3. Total contributions and independent expenditures made this period. Add Lines 1 and 2. Do not enter on the Summa Page.) TOTAL.. $ $2313 p p P ( Summary 9 ) .......... 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 Amounts may be rounded to whole dollars. Statement covers period 10/23/16 from 12/31/16 through CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment SCHEDULE E Page of 1391626 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 IND 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) " Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 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.).. $2313 ....... ............................... $ 0 ....... ............................... $ 0 ....... ............................... $ $2313 ........................ TOTAL $ FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov