Hexagon Transportation - Annual 2017101500115 -NFH -0115
Date Initial Filing
Received
CALIFORNIA • - 700 STATEMENT OF ECONOMIC INTERESTS
Official Use Only
POLITICAL FAIR • •
E -Filed
A PUBLIC D. CUMENT
COVER PAGE
008:39388
Filing ID:
Please type or print in ink.
169840073
NAME OF FILER (LAST)
(FIRST)
(MIDDLE)
Elia, Jeffrey
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Gilroy
Division, Board, Department, District, if applicable
Your Position
Hexagon Transportation Consultants
Consultant
► If filing for multiple positions, list below or on an attachment.
(Do not use acronyms)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi- County
❑ County of
❑x City of Gilroy
❑ Other
3. Type of Statement (Check at /east one box)
❑
x Annual: The period covered is January 1, 2017, through
December 31, 2017
-or-
The period covered is / 1 through
December 31, 2017
❑ Assuming Office: Date assumed I I
❑ Leaving Office: Date Left I I
(Check one)
O The period covered is January 1, 2017, through the date of
leaving office.
p The period covered is I through the date
of leaving office.
❑ Candidate:Date of Election and office sought, if different than Part 1:
4. Schedule Summary (must complete) P. Total number of pages including this cover page: 3
Schedules attached
❑ Schedule A -1 - Investments — schedule attached ❑Q Schedule C - Income, Loans, & Business Positions — schedule attached
❑
x 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-
El None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
8070 Santa Teresa Blvd., #230 Gilroy CA 95020
DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS
( 408 ) 846 -7413 jelia @hextrans.com
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 that the foregoing is true and correct.
Date Signed 03/16/2018
(month, day, year)
Signature Jeffrey Elia
(File the originally signed statement with your filing official.)
FPPC Form 700 (2017/2018)
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov
101500115 -NFH -0115
SCHEDULE A -2
Investments, Income, and Assets
of Business Entities /Trusts Name
(Ownership Interest is 10% or Greater) Flia, Jeffrey
Do- 1. BUSINESS ENTITY OR
Transportation Consultants, Inc.
Name
4 N. Second Street Suite 400
San Jose, CA 95113
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑X Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
Transportation Planning /Engineering
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000 -/ -/- ��-
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑X Partnership ❑ Sole Proprietorship ❑
Other
YOUR BUSINESS POSITION Partner
SHARE OF •• SS INCOME TO THE ENTITY/TRUST)
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑X OVER $100,000
❑ $1,001 - $10,000
Do- 3. LIST THE NAME OF • RTABLE SINGLE SOURCE OF
INCOME OF 0i0 OR MORE
❑ None or ❑X Names listed below
City of Gilroy
EMC Planning Group
Mintier Harnish
Do- 4. INVESTMENTS • INTERESTS IN REAL PROPERTY • OR
LEASED JaY THE BUSINESS ENTITY OR
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity a
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 - / -/- ��-
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OFINTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Comments:
ll� 1. BUSINESS ENTITY OR TRUST
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000 ��-
❑ $10,001 - $100,000 ACQUIRED DISPOSED
❑ $100,001 - $1,000,000
❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
Other
YOUR BUSINESS POSITION
No- 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF -• SS INCOME TO THE ENTITY/TRUST)
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
❑ $1,001 - $10,000
1� 3. LIST THE NAME OF •• RTABLE SINGLE SOURCE OF
INCOME OF $10,000 OR MORE (Attach a separate sheet if necessary.)
❑ None or ❑ Names listed below
PROPERTY No. 4. INVESTMENTS AND INTERESTS IN REAL • LEASED BY THE BUSINESS ENTITY OR
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity pl
City or Other Precise Location of Real Property
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000 -/- ��-
❑ $100,001 - $1,000,000 ACQUIRED DISPOSED
❑ Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership /Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (2017/2018) Sch. A -2
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline:866 1275 -3772 www.fppc.ca.gov
101500115 —NFH -0115
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
Hexagon Transportation Consultants, Inc.
ADDRESS (Business Address Acceptable)
4 N. Second Street Suite 400
San Jose, CA 95113
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Consulting
YOUR BUSINESS POSITION
Principal
GROSS INCOME RECEIVED No Income - Business Position Only
$500 - $1,000 $1,001 - $10,000
$10,001 - $100,000 X❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
Q Salary Spouse's or registered domestic partner's income
(For self - employed use Schedule A -2.)
Partnership (Less than 10% ownership. For 10% or greater use
Schedule A -2.)
Sale of
(Real property car, boat, etc.)
Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
(Describe)
Name
Elia, Jeffrey
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY. IF ANY OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED No Income - Business Position Only
$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
(For self - employed use Schedule A -2.)
❑ Partnership (Less than 10% ownership. For 10% or greater use
Schedule A -2.)
❑ Sale of
(Real property, car, boat, etc.)
Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
(Describe)
* 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
❑ Guarantor
❑ Other
Street address
City
(Describe)
FPPC Form 700 (2017/2018) Sch. C
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov