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410 Statement of Organization Recipient Committee - TerminationRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-54216.5) SEE INSTRUCTIONS ON REVERSE Statement covers period from 07}cull 020 through 12/31/2020 I. Type of Recipient Committee: An committees - Complete parts 1, 2, 3, and 4, ❑ Officeholder, Candidate ControAed Committee ❑ Primarily Formed Balictldeasure D State Candidate Election Committee Committee 0 Recall O Controlled (ALs CnmpterePad S) O Sponsored (A1w Can-,pWu Parrs) '❑� Gen.eraiPerrposeCommittee 0 Sponsored (] Primarily FormedCand€datef (D Smal! GantributorCommittee Officeholder Committee Q Poli Jcal PartyfCenlral Corn mittee fArso Cumprere Pa47) 3. Committee Information I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) CHu, MBE—R OF EGM—MERCY PAC STREET ADD CITY STATE ZIP CODE AREA CODElPHONE . ..5RTIN0 CA 55-a1= MAILING ADDRESS (IF DifFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA COOE)PHONE Date of election if applicable: (Month, Day, Year) Date Stamp R ECEOVE �j n JAN 26, 2021 CUPERTINO CITY CLERK 2. Type of Statement: ❑ Preelection Statement ❑ Semi-annual Statement Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER R:C4A-RD AiRDALAfi MAILING ADDRESS COVER PAGE Page of For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement -Attach Farm 495 CITY STATE ZIP CODE AREA COD&PHONE CDPERTINC CA 952i4 NAME OF ASSISTANT TREASURER, IF ANY jAMES Sn-_aN MAILING AUURE55 CITY STATE ZIP CODE AREA CODFIPHONE SaN FRANC-7sco 'CA - H9 UYIIUNAL: FAX r E-MAIL ADDRESS OPTIONAL: FAX r E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to under penalty of perjury under the laws of the State of California that the foregoing is t Executed on 0-' /2v/2021 oa5 By Executed on By ❑ate Executed an aye Executed on Caw www-neifile.com By sgaapae OF GWWirg O.Ti Xrhddw, Ca tidate. State Measure Pmponard By &tea W reafContrnl!d� OFficaFrolder, Candidate, Sraie Me®T;is AFoperc�L true and complete. t certify FPPC Form 460 {Janf20M FP PC Advice: advice@fppc.ca.gov (8661276-3772) www.fppc.ca.gov Recipient Committee COVER PAGE - PART 2 Campaign Statement CALIFORNIA. I Cover Page — Part 2 FORM Page 2 of 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE OFFIOE SDUGHTOR HELD {INCLUDE LOCATION AND DISTRICT NUMBER iFAPPL]CAt3LE) BALLOT MO. OR LETTER FUItISDICTION ❑SUPPORT ❑ OPPOSE RESIDENTIALIBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE. OR PROPONENT Related Committees Not Included in this Statement: List any committees not included in this statement that are confrofled by you or are primarily formed to receive OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OFTREASURER CONTROLLED COMMITTEE? 7. Primarily Formed Candidate/Off iceholder Committee List names of afceholrier(sj or candidate(s) for which this committee is primarily formed. Ej YES ❑ NO COMMITTEEAD DRESS STREETADDRESS {NO P.O. BOX) CI T Y STIVE ZIP CODE AREA CODEW LONE COMMITTEENAME LD_ NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? YES [ NO COMMITTEEADDRESS STREETADDRESS (NO P.Q. BOX) 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 KAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELL ❑ SUPPORT ❑ OPPOSE - _ • ` "ram"'"` Attach continuation sheets if necessary FPPC Forst 460 (Jan=16) FPPC Advice: advice@fppc.ra.gov (86$I275-3772) tA+1+IrW.f7etflB. Ct3ril www.fppc.r-a.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER CUPE_LT=td.3 CHAMBER OF COL"ERCE PAC Contributions Received Amounts may be rounded to whole dollars. 1. Monetary Contributions ____....... -- ........................... schedule A, tines $ 2. Loans Received .--- ...................... ..... -...--------- .... ---- .. schedule a Lirre 3 3. SUBTOTALCASH CONTRIBUTIONS .....--- Add Lines f +2 5 4. Nonmonetary Contributions.. - ........... .......... _ ....... SctbeduleC.Line3 5, TOTAL CON TRI BUTION S RECEIVED ......................... AddLines3+4 5 =xpenaitures wiaae Statement covers period frorn 07/01/202.) through Column A Column B TOTALTH IS PEPMD CALEN DA.R YEAR {FROM ATrACNED SCHEDULES) TOTAL 70 DATE ?,oc0.aa S 3 =ac sa 00. or. 0.O; a-00 2,000.00 � 3,50a.00 6. Payments Made.-----..... ...................................... schedule F. Lne 4 S 3, EI83. 32 7. Loans Made .................................................. SCheduleH,Lirne3 0.01, 8- SUBTOTAL CAS HPAYMENT5....................... ............. Add Lines s+r S a '363.3= 9. Accrued Expenses (Unpaid Bills) ............... ................SeheduleF,Line3 -15,099.61 10. Nonmonetary Adjustment ......... ......................--......... Schedule c, Une s a- a 11. TOTAL E7CPENDITURESMADE .... ................ Add unes8+9+xo Current Cash Statement 12. Beginning Cash Balance.... ...... .... Prevraus5umrrraryl'age. L'ne 7S $ 13. Cash Receipts ...... -....-.................. ..-....._........... ColurrrnA.Line 3above 14. Miscellaneous Increases to Cash .......................... schedule r, Line 18_ Cash Payments ........................ .............----. ColumrrA, One 8 above 16. ENDING CASH BALANCE .......... Add tares 12 + 13 + 14. then subtract Line 15 S If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule 8, Part 2 5 803-'s2 2,07C.u0 0� 3,083.32 a.an r-d2 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ see instruchansonreverse 19. Outstanding Debts ............. ..-. Add brre 2 +Line 9 in Cotumn B abpve $ 0 C www.neffile.com SUMMARY PAGE ,2131�2C20 Page 3 of 9 I.D. NUMBER 1299673 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections if9 9hrough 6130 V1 to Date 21). Contributions Received $ 21. Expenditures M ade g Expenditure Limit Summary for State 5 4,032.32 Candidates 22. Cumulative Expenditures Made* 0.0C (tFSubjectroVoluntar)rExpencaWreLimltl 0 Data of Election Total to Date 0.0 p (mmIddlyy) -lam 5 $ 4,a--- 2.3- To calculate Column B, add amounts in Column A to the corresponding amounts `Amounts in this section may be different from amounts from Column B of your last reported in Column B. report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If Ibis is the first report being fled for this calendar year, only carry over the amounts from Lines 2, 7, and g (if any). FPPC Form 460 (Jan12016} FPPC Advice: advire@fppc.ca.gov (8561275-3772) www.fppc.r-a.gov Schedule A SCHEDULE A Monetary Contributions Received Amounts may rounded Statement covers period to whale doolf lars. pCALIFC)RNIA� from 0±f0r/2020 • " SEE INSTRUCTIONS 041 REVERSE NAME OF FFLER CUPERTT`:C C kMBER OF CCYMERCE PAC through 12}31/202D 1 Page a of 9 DATE FULL NAME. STREET ADDRESS AND ZIP CODE OF COMTRIBUTOR I CONTRIBUTOR IF AA INDMOUAL. ENTER AMOUNT RECEWED(IF COMMrrEE.ALSO ENTERco_NUM-3ER) CODE OCCUPATIONANDEMPLOYER RECEIVED THIS [:F SELF-EMPLOYED. ROER R:ME PERIOD rjJ Cm BuSINESs} 07/30/2020 ASDF-.AF 1AW OFFICES A PROFESS-CITAI =.AW ❑IND 1,0 0.00 CORPCRUALIOV GENERAL ACCOUNT [COM CUP7-RTTNO, Cr 9501� MOTH ❑ PTY ❑ SCG 3}1d}2 2^ SAP; JOSE WA^uR COMPANY ❑IND S3" JOSE, C.A. :515c ❑COM ❑E OTH ❑1 PTY ❑SCC ❑ `ND ❑ Gom �] OTH PTY ❑ SCC ❑iND ❑ICOM ❑ 0TH ❑ PTY ❑ SCG ❑ IND ❑Com ❑ OTH ❑ PTY ❑SCC SUBTOTAL$ 2,00D.Do Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule subtotals.)... ............ $ 2, CC- 0a. tie 2. Amount received this period — un'tern ized monetary GontribAions of less than $100 ............................ $ 0.00 3_ Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, e, Column A, Line 1.). - ............... ----- TOTAL S 2, 000. CO www.neffile.com I.D. NUMBER I299G73 GUMUiATIVETODATE PERELEGTIQN GALENDAR YEAR TO DATE (JAN. t - DEG. 31) (IF REQUFREID} 0c.0a 11500,110 'ContributorCodes IND— Individual COM — RecipientCommittee (older tha rn PTY or SCG) OTH — Other (e.g.. business entity) PTY — Political Party SCG—Small Contributor Committee FPPC Form 460 (3anl2616) FPPO Advice: advice@fppc.ca.gnv (866f27"772) www.fppe.ca.gov Schedule C Nonmonetary Contributions Received SEE 3NSTRUCTSONS ON REVFR. NAME Ur HLEK CDPER7-IF0 Cci:ffBER OF COMMERCE PAC DATE FULL NAME. STREET ADDRESS AND RECEIVED ZIP CODE OF CONTRIBUTOR OF COMMITTEE. ALSO E%IrER I_D. NUMBER) 12/31/2020 CUPERTINC CAAM3ER OF (0VINI .R^v PER"TNO CEAMB1 _R, CA 95G19 Amounts may be rounded to whole dollars. Statement covers period from 0YV1/2C20 through 12/31/2020 CONTRIBUTOR CODE * IF AN INOMDUAL. ENTER AMOUNT! OCCUPATION AND EMPLOYER DESCR I PTION OF FAIR MARKET {IF SELF-I=MP�OYEO.ENTER GOO DS OR SER1ACES VALUE NAk+.E OF BUSINESS] ❑tND PP. Rails: OF PAC 0.0 JAM ADM_A 7 5 T RATI :F3 ❑OTH SERVICES BY SPONSOR F__i ❑ PTY 59901..9g ❑SOC ❑IND r—'Com OTH PTY ❑ SCC ❑ Jhip ❑CDM ❑ OTH [] PTY ❑ SCC ❑ IND ❑COM ❑ 4TH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTALS D . C 0 Schedule C Summary 1. Amount received this periatf — itemized nonmcnetary contributions. (Include all Schedule C subtotafs.) ........................................................_., $ o .00 2. Amount received this period — unitemized nonmonetary contributions of less than $100 ............ ......... s 0.00 3. Total nonmcnetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) TOTAL $ 0 - D0 www.netrile.com LE C Page 5 of I.D. NUMBER 1259673 CUMULATIVE TO DATE PER ELECTION CALENDAR YEAR TODATE (JAN 1 - DEC 31) (IF REQUIRED) 0.00 *Contributor Codes IN❑ -- Individual COM — Recipient Committee (other than PTY or SCG) CTH — Other (e.g., business entity) PTY— Political Party SCC —Small ContribWor Committee FPPC Form 460 (Jan12016) FPPC Advice: advfce@fppc.ca_gov (866I27'5-3772) www.fppc. ea. goV Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER CC= RTINC CHAMBER OF COMMERCE PAC Amounts may be rounded to whole dollars. Statement covers period from C-7/01/202', through 12/31/2020 SCHEDULE E Page 4 of y I.D. NUMBER 1299673 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CW campaign paraphemaliafmisc. M2R member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned conEributions GTB contribution {explain nonmonetary)' OFG office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t_v. or cable airtime and production costs FIL candidate Blinglbailot fees PHD phone banks TRC candidate [ravel, lodging, and meals FND fundraising events POL polling and survey research TRS sta€ffspouse travel, lodging, and meals M independent expenditure supportinglopposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidatetsponsor LEG legal defense FRO professional services {legal, accounting] VOT voter registration LTT campaign literature and mailings PRT print ads WEB information technalogy costs (internet, e-mail) NAME AND ADDRESS OF PAYEE fIF OMMMEE. ALSO ENTER I.D NUMBERI 5 �`, ct2-:iuCISCO. Ct 59 iG' n=.P K OF i E :BEST BANK O ^AF: WEST SAN 2Rn_aCTSCC, CA CODE OR 0ESCRIPT10N OF PAYMENT 0=v OFC 0_C * Payments that are contributions or independent expenditures must also be summarized on Schedule D. AMOUNT PAID 2-CO .0 1_�.1.0 SUBTOTAL.$ 16. a 0 Schedule E Surnrnary 1. Itemized payments made this period. (Include all Schedule E subtotals_) .... ............. ....................... .... $ 3, 883. 32 2. Uniterrlizedpayments mladethispenodofunder $100............... ....................... ................._........_... s 0.DO 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e)) $ O.O G 4_ Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ 3,883.32 www.netfife_com FFPC Form 460 (Jan12016) FPPC Tolt-Free Helpline: 8661ASK-FPPC (86S1275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE TAME OF FILER CUPER71 O C'iAN,3ER OF COMMERCE RFC Amounts may be rounded to whole do liars. Statement covers period from 07/01/202v through=2111/2020 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment SCHEDULE E (CONT Page 7 of 1_1) NUMBER 251n73 CW campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returrred contributions GTB contribution (explain nonmonetary)' CFC office expenses SAL campaign workers' salaries GVC civic donations PET petition circulating TFL t.v. or cable airtime and production costs FlL candidate filinglballot fees PHD phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS stafflspouse travel, lodging, and meals M independent expenditure supportingfopposing otfilers (explain)" POS postage, delivery and messenger services TSF transfer between committees of the same calndidatelsponsor LEG Jegal defense PRO professional services (legal, accounting) VOT voter registration LFT campaign literature and mailings PRT pnnt ads V1EB informatw technology costs (internet, e-mail) NAME AND ADD R FSS OF PAYEE pF COMf�irr7EE. ALSO ElITER I.D. NUMSER} CODE OR 0ESCRIP-nON0FPAYMENT AMOUNT PAID BALK OF THE WES- O_C � y-�0 SA CA 94101 S�77011 L:ii FIRI-] p t SA--.C- BANE OF THE WEST CFC .20 3AP:a = 21:� NEST DF SPM f-;;NCISCC, CA 5!__05 BANK OF THE WES^ OFC SPUN FRANCISC0, CA 94101 * Payments that are contributions or tridependent expendftures must also be summarized on Schedule D_ SUBTOTALS 2,330.21 FPPC Form 460 (Janl2016) I PPCToil-FreeHelpline:866lASK-FPPC(86U27"772) www.,7e#file. COrl7 www.fpp-c.ra.gov Schedule E SCHEDULE E (CONT. (Continuation Sheet) Amounts may herounded Statement covers period CALIFORNIA Payments Made to whole dollars. • _ 1 60 from u;{011202C� SEE: I NSTRU CTION S ON REV E RS E through Page 8 of 9 NAME OF FILER I.D. NUMBER C:aFERTINO CHAz 3ER OF CCM-1VIFRCE PAC 1299673 CODES, if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CAP campaign paraphemalialmisc. MBR member com munications RAD radio airtime and production costs CNS Campaign consultants MTG meefings and appearances RFD returned contributions CTt3 contdbution (explain norimonetary)" DFC office expenses SAL campaign workers' salaries CVC civic donations FIL candidate filingfhallot fees PH PHO petition circula€ing banks TEL Lv_ or cable airtime and production costs FND fundraising events POL phone polling and survey research TRC TRS candidate travel, lodging, and meals staffJspouse travel, lodging, and meals M independent expenditure supportinglopposing others {explain}' PO.S postage, delivery and messenger services TSF transfer between committees of life same candW atels pans or LEG IegaE defense PRO professional services (legal, accounting) VOT voter registration UT campaign literature and mailings PRT print ads VVEB information technology casts (internet, e-mail) nr,rvet ArQU F1uUS JttJ Uh PAY LL (IF COMMITTEE_ ALSL` ENTER 1.0. KLIMBER} 3ANR OF T E WEST S'Alq F '-1t3''Ci S.".v' BANE OF Tom= WES BANK O: _'UE WEST S.PN -._KPiCIS,. , CA _ 104 S:13 FRt' =SCC, Cr'. g4 D2 k3SE-ET_t AC N SAN JCSE, CA r5_25 CODE OR 01 SC RIPTiONOFPAYMENT aw FRO PRO * Payments that are contributions or independent expenditures must a Iso be summarized on Schedule D. AMOUNT PAID 3.0C ?1.31 1,45-�-G0 SUBTOTAL $ 1, 51 ; .31 FPPC Form 460 (Janf2ot6) FPPC Toll -Free Heipiline: 8WAS K-FPPC (8661275-3772) www.tietfile.com www.fppc.ca.gov Schedule F Accrued Expenses (Unpaid Sills) amotowholunts ybllars. rounded to whole dollars. SEE LNSTRUCTLONIS ON REV rvnrrtt Vr 1' 1LLN CUFER^IND C.-IAI-]BER OF CO-Y&IERCE PA-. 5tatementcovers period from • 7fG1/2020 through 12/31f202•; SCHEDULEF I:ALI NIA 460 FOR{tMM �� I -NUMBER 1259;~73 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment, CW CNS campaign paraphemaliafmise. MBR member communicaGons RAD radio airtime and production costs CTR campaign consultants MTG meetings and appearances RFD returned contributons coafribulion (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVG RL civic donations candidate flingfballot fees PET peGfion circulating TEL t.v. or cable airtime and production casts FND fundraising events PHO phone banks Tl C candidate travel, lodging, and meals PLC independent expenditure supportinglopposing others (explain)` POL polling and survey research POS TRS stafffspouse travel, lodging, and meals LEG regal defense postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor UT PRO professional services {legal, accounting) VOT voter registration campaign literature and mailings PRT print ads VVEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR nFroM n E. LsoErarERro_n,uMaE�L CODE OR DESCRIPTION OF PAYMENT W OUTSTANDING {b) AMOUNTINCURREE (c) AMOUNTPAID (d) OUTSTANDING BALANCE BEGMNING THI5PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD Lassa REPORT ON Q OF THIS PERIOD =-RIS 3AzN=-S W2 THE GF CtS; DE=T J I: 422 -1_,c2� 3L C. G IJNC0- LE : T 13L^. O.GO SA-1-1 =R2UJCTSC0, CA 991 = TF,Rz.IS =` =' - - INN OF '— S; DEST 0 CO:,LECTI3i; 3,�'o?.3i -1,5c"7.31 �).�-G 0.G�CA 2�4106 * Payments that are contributions or independent expenditures must also be SUBTOTALS Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitem ized accrued expenses under$100.) ............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100,) ..-- ........... PAID TOTALS $ 3, Net change this period. (Subtract Line 2 from Line 1. Enter the citerence here and on tlhe S P C f -15, 089. E.•- 0.GG ummary age, o umn A, Ltne v.) ............................ ..- ..................... .,...... NET $ -15, c89.61 May "a n a�w r ber FPPC Form 460 (Jan12416) FPPC To fl-Free Hel pli ne: SWAStt-FPPC (8661275-3772) www.netrile.com corm www.fppc-ca. gov