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Hexagon Transportation - Annual 2016 Date Left // (Check one) The period covered is //, through the date STATEMENT OF ECONOMIC INTERESTS COVER PAGE FPPC Form 700 (2016/2017) FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov (month, day, year) (Check at least one box) State Multi-County County of City of Other (Check at least one box) Election Year and o // 700 FAIR POLITICAL PRACTICES COMMISSION CALIFORNIA FORM Agency Name Division, B () NAME OF FILER (LAST) (FIRST) (MIDDLE) Investments – schedule attached Investments – schedule attached Real Property – schedule attached ( ) (Business or Agency Address Recommended - Public Document) Income, Loans, & Business Positions – schedule attached – schedule attached – schedule attached No reportable interests on any schedule A PUBLIC DOCUMENT CourtCommissioner The period covered is January 1, 2016, through The period covered is //, through December 31, 2016 -ILDDRESS Date assumed FPPC Advice Email: advice fppc.ca.gov@ Dnotuseacronyms Dnotuseacronyms December 31, 2016 the date of The period covered is January 1, 2016, through lntiallng Received 101500115-NFH-0115 Elia, Jeffrey City of Gilroy Hexagon Transportation Consultants Consultant X Gilroy X 3 X X 8070 Santa Teresa Blvd., #230 Gilroy CA 95020 408 846-7413 jelia@hextrans.com 03/15/2017 Jeffrey Elia E-Filed 03/15/2017 16:20:12 Filing ID: 164002142 IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED SCHEDULE A-2 of Business Entities/Trusts Comments: Name Address (Business Address Acceptable) Name Address (Business Address Acceptable) INVESTMENT REAL PROPERTY Description of Business Activity or City or Other Precise Location of Real Property Check one Trust, go to 2 Business Entity, complete the box, then go to 2 Check one Trust, go to 2 Business Entity, complete the box, then go to 2 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF (Attach a separate sheet if necessary.) 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) Name 700 Check one box: FPPC Form 700 (2016/2017) Sch. A-2 FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov FAIR MARKET VALUE $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 $0 - $499 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 OVER $100,000 INVESTMENT REAL PROPERTY Description of Business Activity or City or Other Precise Location of Real Property 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF (Attach a separate sheet if necessary.) 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) Check one box: FAIR MARKET VALUE $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 $0 - $499 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 OVER $100,000 FAIR POLITICAL PRACTICES COMMISSION CALIFORNIA FORM 1. BUSINESS ENTITY OR TRUST 1. BUSINESS ENTITY OR TRUST NATURE OF INTEREST Stock Partnership Leasehold Other Check box if additional schedules reporting investments or real property are attached NATURE OF INTEREST Stock Partnership Leasehold Other Check box if additional schedules reporting investments or real property are attached IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED FAIR MARKET VALUE $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 GENERAL DESCRIPTION OF THIS BUSINESS YOUR BUSINESS POSITION NATURE OF INVESTMENT Partnership Sole Proprietorship Other $0 - $1,999 IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED FAIR MARKET VALUE GENERAL DESCRIPTION OF THIS BUSINESS $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 YOUR BUSINESS POSITION NATURE OF INVESTMENT Partnership Sole Proprietorship Other $0 - $1,999 Assessor’s Parcel Number or Street Address of Real Property Name of Business Entity, if Investment, or Assessor’s Parcel Number or Street Address of Real Property Name of Business Entity, if Investment, or None None FPPC Advice Email: advice fppc.ca.gov@ 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST or Names listed below or Names listed below Elia, Jeffrey 101500115-NFH-0115 Hexagon Transportation Consultants, Inc. 4 N. Second Street Suite 400 San Jose, CA 95113 X Transportation Planning/Engineering X X Partner X X City of Gilroy EMC Planning Group SCHEDULE C Positions (Other than Gifts and Travel Payments) GROSS INCOME RECEIVED Name FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov OVER $100,000 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 700 FAIR POLITICAL PRACTICES COMMISSION CALIFORNIA FORM 1. INCOME RECEIVED NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION 1. INCOME RECEIVED NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION NAME OF LENDER* ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) None HIGHEST BALANCE DURING REPORTING PERIOD $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 OVER $100,000 GROSS INCOME RECEIVED OVER $100,000 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 Comments: 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * 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: SECURITY FOR LOAN None Personal residence Real Property Guarantor Other Street address City (Describe) CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary Spouse’s or registered domestic partner’s income Partnership (Less than 10% ownership. For 10% or greater use Sale of Commission or Rental Income, list each source of $10,000 or more Other (Describe) FPPC Form 700 (2016/2017) Sch. C Realp FPPC Advice Email: advice fppc.ca.gov@ (For self-employed use Schedule A-2.) Loan repayment (Describe) Schedule A-2.) CONSIDERATION FOR WHICH INCOME WAS RECEIVED Salary Spouse’s or registered domestic partner’s income Partnership (Less than 10% ownership. For 10% or greater use Sale of Commission or Rental Income, list each source of $10,000 or more Other (Describe) Realp (For self-employed use Schedule A-2.) Loan repayment (Describe) Schedule A-2.) No Income - Business Position OnlyNo Income - Business Position Only 101500115-NFH-0115 Elia, Jeffrey Hexagon Transportation Consultants, Inc. 4 N. Second Street Suite 400 San Jose, CA 95113 Consulting Principal X X