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Harris & Associates - Annual 2012CALIFORNIA FORM 700 1 STATEMENT OF ECONOMIC INTERESTS w Date Received Date al Use Only FAIR POLITICAL PRACTICES COMMISSION PUBLIC DOCUMENT COVER PAGE Please type or print in ink. .• cut., r NAME OF FILER (LAST) (FIRST) Gultez Robert 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable ► If fling for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi- County ❑✓ City of Gilroy Your Engineer- Harris & Associates, Inc. Position: ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other 3. Type of Statement (Check at least one box) © Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left J__J -or- December 31, 2012. (Check one) The period covered is through O The period covered is January 1, 2012, through the date of December 31, 2012. leaving office. ❑ Assuming Office: Date assumed O The period covered is , through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1: 4. Schedule Summary Check applicable schedules or "None." ► Total number of pages including this cover page: 1 ❑ Schedule A -1 - Investments- schedule attached ❑ Schedule C - Income, Loans, & Business Positions- schedule attached ❑ Schedule A -2 - Investments- schedule attached ❑ Schedule D - Income.- Gifts - schedule attached ❑ Schedule B -Real Property - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached -or- Z None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE /Business or Agency Address Recommended � Public Document) Concord CA 94520 ( 925 ) 827 -4900 I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California @fppe.ca.gov FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov Please type or print in ink. NAME OF FIL Dobbins 1. Office, Agency, or Court STATEMENT OF ECONOMIC INTERESTS COVER PAGE Patrick M "Date Recerved�,, - om�,er ee omy� APR 2013 ��'�i°pCLERBS p .cmn- �tMIiSdL'ei.. Agency Name - City of Gilroy Division, Board, Department, District, if applicable Your Position &ING1 Nm� 140 WrT Consultant P. If fling for multiple positions, list below or on an attachment Agency: 2. Jurisdiction of Office (check at least one box) ❑ State ❑ Multi- County © City of Gilt Position: ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other — 3. Type of Statement (check at least one box) m Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left ---J---J December 31, 2012. (Check one) -or- The period covered is December 31, 2012. ❑ Assuming Office: Date assumed ❑ Candidate: Election year 4. Schedule Summary Check applicable schedules or "None." ❑ Schedule A -1 - Investments - schedule attached ❑ Schedule A -2 - Investments - schedule attached ❑ Schedule B - Real Property- schedule attached through O The period covered is January 1, 2012, through the date of leaving office. O The period covered is __J__J , through the date of leaving office. and office sought, if different than Part 1: ► Total number of pages including this cover page: 3 0 Schedule C - Income, Loans, & Business Positions - schedule attached ❑ Schedule D - Income - Gifts - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached -or- ❑ None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended � Public Document) Gilroy CA 95020 ( 408 ) 710 -9866 I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a public Date Signed 04/01/2013 (month, Signature FPPC Form 700 (2012/2013) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 666 1275 -3772 www.fppc.ca.gov SCHEDULE A -1 Investments Stocks, Bonds, and Other Interests (Ownership Interest is Less Than 10 %) Do not attach brokerage or financial statements. ENTITY Vanguard GENERAL DESCRIPTION OF BUSINESS ACTIVITY IRA FAIR MARKET VALUE ❑ $2,000 - $10,000 ® $100,001 - $1,000,000 ❑ $10,001 - $100,000 ❑ Over $1,000,000 NATURE OF INVESTMENT Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More ( Repod on Schedule C) IF APPLICABLE, LIST DATE: __J___J 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY Vanguard GENERAL DESCRIPTION OF BUSINESS ACTIVITY Brokerage Account FAIR MARKET VALUE ® $2,000 - $10,000 ❑ $10,00l - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT err bStock F1 Other J- (Describe) ❑ Partnership O Income Received of $0 - $499 Q Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: __j --- J 12 _—J--J-12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: __J__J 12 __J_J 12 ACQUIRED DISPOSED Comments: CALIFORNIA FORM 700 PAIR POLITICAL PRACTICES COMMISSION Name Patrick Dobbins Fildelity GENERAL DESCRIPTION OF BUSINESS ACTIVITY 401k FAIR MARKET VALUE ❑ $2,000 - $10,000 0 $100,001 - $1,000,000 NATURE OF INVESTMENT Q Stock ❑ Other_ ❑ $10,001 - $100,000 ❑ Over $1,000,000 (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,00l - $700,000 ❑ $100,001 - $1,000,000 ❑ Over $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: __J__J 12 ... J_/ 12 ACQUIRED DISPOSED ► NAME OF BUSINESS ENTITY GENERAL DESCRIPTION OF BUSINESS ACTIVITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $100,001 - $1,000,000 NATURE OF INVESTMENT ❑ Stock ❑ Other. ❑ $10,001 - $100,000 ❑ Over $1,000,000 (Describe) ❑ Partnership O Income Received of $0 - $499 O Income Received of $500 or More (Report on Schedule C) IF APPLICABLE, LIST DATE: _I ( 12 ACQUIRED DISPOSED FPPC Form 700 (2 0 1 212 01 3) Sch. A -1 FPPC Advice Email: adviceCafppc.ca.gov FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME Harris & Associates ADDRESS (Business Address Acceptable) Gilroy CA 95020 BUSINESS ACTIVITY, IF ANY, OF SOURCE Engineering Consultant YOUR BUSINESS POSITION Sr Project Manager GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ® OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ® Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Partnership ❑ Sale of (Real property, car, boat, etc.) ❑Commission or E] Rental Income, list each source of $10,000 or more ❑ Other Name Patrick Dobbins NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Partnership ❑ Sale of (Real property, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source or$10,000 or more ❑ Other You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER" ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 Comments: INTEREST RATE TERM (Months/Years) % ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property Street address City ❑ Guarantor ❑ Other (Dasolbe) FPPC Form 700 (2012/2013) Sch. C FPPC Advice Email: advice @fppc.ca.gov FPPC Toll -Free Helpline: 8661275 -3772 www.fppc.ca.gov