HomeMy Public PortalAboutForm 460 (Jan 21 - Feb 17, 2001)Recipient Committee
Campaign Statement
(Government Code Sections 84200-84216.5)
type or print In Ink
Statement covers period
from 1/~1/nl
SEE INSTRUCTIONS ON REVERSE
through 2/17/01
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 7
®Officeholder, Candidate ^ Primarily Formed Candidate/
Controlled Committee Officeholder Committee
(A/so Comp/ete Ped 4.J (A/so Comp/e/e Pelf 6.J
^ Ballot Measure Committee ^ General Purpose Committee
Q Primarily Formed Q Sponsored
Q Controlled Q Broad Based
Q Sponsored
(A/so Comp/efe Pact 5.J
I.D. NUMBER
3. Committee Information Not yet received
COMMITTEE NAME
Bo Bollinger for City Council
STREET ADDRESS (NO P.O. BOX)
306 Alamosa Drive
- CITY STATE ZIP CODE AREACODE/PHONE
Claremont, CA 91711 (909) 399-9201
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
clrY
STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
Dale Stamp
COVER PAGE
~l.r ~ ~ iI
Date (MonUl, Day, Yearl)cable. I FE8 ~ ~ LOO I
Page ~ of ~~
For Official Use Only
3/6/01
2. Type of Statement:
® Pre-election Statement
^ Semi-annual Statement
^ Termination Statement
^ Amendment (Explain below)
^ Quarterly Statement
^ Special Odd-Year Report
^ Supplemental Pre-election
Statement -Attach Form 495
Treasurer(s)
NAMEOFTREASURER
Cynthia J. Sullivan
MAILING ADDRESS
1016 Emory Drive
CITY STATE ZIP CODE AREACODE/PHONE
Claremont, CA 91711 (909) 625-1303
NAME OF ASSISTANT TREASURER, IF ANY
Adam Russell
MAILING ADDRESS
1569 Seneca Place
CITY STATE ZIP CODE AREACODE/PHONE
Claremont, CA 91711 (909) 624-0344
OPTIONAL: FAX/E-MAIL ADDRESS
FPPC Form 480 (8/99)
For Technical Assistance: 916/322-5660
State of California
Type or print In Ink. COVER PAGE -PART 2
Recipient Committee
Campaign Statement ~ ~ ~ ~ • 1
Cover Page -Part 2
Page 2 of -1~
4. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Bernard D. Bollinger, Jr.
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
-City Council, City of Claremont
• RESIDENTIAUBUSINESSRDDRESS (NO. AND STREET) CITY STATE ZIP
306 Alamosa Drive, Claremont,. CA 91711'
Related Committees Not Included In this Statement: c/sranycommMfees
not /nc/uded/n th/s conso//dateds/atemen/lhata~ contra//edbyyou of wh/ch ere pr/marfty
formed /o ace/ve conb/but/ons or to make expend/tuies on belie/fo/yourcand/dacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
^ YES ^ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
5. Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I JURISDICTION I ^ SUPPORT
^ 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
6. Primarily Formed Committee L/sfnamesofo/Y/ceho/de~'sJorcand/dafel/sJ
for wh/ch 1h/s comet/Mee /spn'mer//y/onnea!
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ^ SUPPORT
^ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD ^ SUPPORT
^ OPPOSE
OFFICE SOUGHT OR HELD ^ SUPPORT
^ OPPOSE
A/lach aonBnua/ion shee/s ifnecessary
• 7. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules
is true and complete: I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
1
.,~ _
~ i
Executed on ~n ~~ By ~1' <- ! , ; -~-'
DAT /~ ~ SIGNA RE OFT,R(/SURE~RORASS`IS/TANTTREASUR~ERi
Executed on ~/~~~ ;iy ~ gy v'.~~.~~/'r/. /' _~ ~e~~ .'.1iC
DATE ~ SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE ROPON6 OR RESPONSIBLE OFFICER OF SPONSOR
EXecuted On
DATE
Executed on
DATE
By
SIGNATURE OF CONTROLLING OFFlCEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 460 (t3/99)
For Technical Assistance: 916/322-5660
State of California
Campaign Disclosure Statement Type orprlntlnlnk. SUMMARY PAGE
Amounts maybe rounded Statement covers period ~ e . '
Summary Page to whole dollars. 1/21/01 , '
from ~
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Bernard D. Bollinger, Jr./Bo Bollinger for City Council
through 2~17/O1 I Page 3 of 10
Contributions Received
1.
•2.
3.
4.
5.
Monetary Contributions ......................................................
Loans Received ...................................................................
SUBTOTAL CASH CONTRIBUTIONS ..................................
Nonmonetary Contributions ...............................................
Column A Column B•
TOTAL THiS PERIOD TOTAL PREVIOUS PERIOD
(FROM ATTACHED SCHEDULES) (SEE NOTE BELOVI~
Schedu/e A, Line 3 $ 4 , 441.00 $ 7 , 211 .00
Schedu/e B, Line 7 ~
Add Lines > + 2 $ 4, 441.00 $ 7 , 211.00
Schedu/e C, Line 3 0 0
TOTAL CONTRIBUTIONS RECEIVED .................................... .odd lines 3+ 4 $
I.D. NUMBER
Not yet received
Column C
TOTAL TO DATE
(COLUMNS A + B)
$ 11,652.00
0
$ 11,652.00
0
4,441.00 $ 7,211.00 $ 11,652.00
Expenditures Made
6. Payments Made .................................................................... scnedu/e E, tine 4
7. Loans Made .......................................................................... scnedure H Line ~
8. SUBTOTAL CASH PAYMENTS ............................................ .... Add[/nes s+ ~
9. Accrued Expenses (Unpaid Bills) ............................................ Schedu/e F, tine 3
10. Nonmonetary Adjustment ..................................................... .. Schedu/e c, tine 3
11. TOTAL EXPENDITURES MADE ......................................... Add Lines B + 9 + >0
$ 3,109.08 $ 5,028.84 $ 8,137.92
0 0 0
$ 3,109.08 $ 5,028.84 $ 8,137.92
0 0 0
0 0 0
$ 3,109.08 $ 5,028.84 $ 8,137.92
Current Cash Statement
• 12. Beginning Cash Balance ................................ Previous summery Page, tine >s
13. Cash Receipts .............................................................. coiumn,a, Line3ebove
14. Miscellaneous Increases to Cash ....................................... schedule i Line 4
15. Cash Payments ............................................................ co/umn A, Line 8 above
16. ENDING CASH BALANCE .............. AddGines >2 + >3+ >4, then subliecl Line >5
//this is a termination statemenl, Line >6 must be zero
$ 2 , 182.16 • From previous statement Summary Page, Column C. However, if this
4 , 441.00 is the first report filed for the calendar year, Column B should be blank
except for Loans Received (Line 2), Loans Made (Line 7), and Accrued
0 Expenses (Line 9).
3,109.08
$ 3,514.08
17. LOAN GUARANTEES RECEIVED ................... Schedu/e B, Perr >, Cotumn (b) $ ---
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ..................................................... see instructions on reverse $ ---
19. OUtstanding DebtS ................................... Add Line 2 + Line 9 in Co/umn C above $ ---
Summary for Candidates in Both June and
November Elections
1/1 through 6/30 7/1 to Date
20. Contributions
---
---
Received ............ $
21. Expenditures --- --_
Made .................. $
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
•
Schedule A
Typo or print in Ink.
SCHEDULE A
r~mounu;f may oe rounaea
Monetary Contributions Received t
h
t
d
ii Statement covers clod
.-
~
ow
o
ars.
o
e ~ ~
~
from 1 /~ 1 /nl ~ '
SEE INSTRUCTIONS ON REVERSE through 2/17/01 page 4 of 10
NAME OF FILER
I.D. NUMBER
Bernard D. Bollinger, Jr./Bo Bollinger for City Council Not yet received
DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER AMOUNT
RECEIVED THIS CUMULATIVE TO DATE
CALENDAR YEAR CUMULATIVE TO DATE
OTHER
RECEIVED CODE
(IFSELF-EMPLOYED, ENTER NAME
PERIOD
(JAN.1-DEC. 31)
(IFAPPLICABLE)
OF BUSINESS)
1/22/01 Kevin Brandt ®IND Attorney, Buchalter
50 N. Arroyo Boulevard ^ COM Nemer, Fields & 250.00
Pasadena, CA 91105 ^ OTH Younger
1/22/01 Jeff Kapor ®IND Attorney, Buchalter
9567 Melvin Avenue ^ COM Nemer, Fields & 250.00
Northridge, CA 91324 ^ OTH Younger
1/22/01
Ben Kayashima ®IND Judge, State of
395 Madison ^ COM California and
99.00
Pomona, CA 91767 ^ OTH County of San Bern.
1/22/01 Barbara McAlister ®IND
2548 N. Mountain
^ COM
Retired 100.00
Claremont, CA 91711 ^ OTH
1/23/01 Kathy Nelson ®IND Teacher, Elk Grove
8929 Blakemore Court ^ COM Unified School 75.00
Elk Grove, CA 95624 ^ OTH District
SUBTOTAL $ 774.00 '~,~,~ r ~°g~~
Schedule A Summary
1. Amount received this period -contributions of $100 or more.
(Include all Schedule A subtotals.) ....................................................................................................... $ 2, 873.00
2. Amount received this period - unitemized contributions of less than $100 ......................................... $ 1, 568.00
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ................... TOTAL $ 4, 441 .00
'Contributor Codes
IND -Individual
COM -Recipient Committee
OTH -Other
FPPC Form 460 (8/99)
For Technical Assistance: 91 6132 2-5 66 0
•
•
Schedule A (Continuation Sheet)
Type or print In Ink
SCHEDULE A (CONT.)
monetary Contributions Received Amounu~maycerounaea Statement coversperlod
'
to whole dollars. •
~ '
~
from 1/21/01 • '
through 2 17/01 Page~1`- ofL~
NAME OF FILER I.D. NUMBER
Bernard D. Bollinger, Jr./Bo Bollinger for City Council Not yet received
DATE
FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR
F C
CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER AMOUNT
RECEIVED THIS CUMULATIVE TO DATE
CALENDAR YEAR CUMULATIVE TO DATE
OTHER
RECEIVED (I
OMMITTEE, ALSO ENTER I.D. NUMBER) CODE • (IFSELF-EMPLOYED, ENTER NAME
OF BUSINESS)
PERIOD
(,JAN 1 -DEC 31)
(IF APPLICABLE)
Randall Prout ®IND Randall S. Prout,
1/23/01 651 West 9th Street ^ COM State Farm 99.00
Claremont, CA 91711 ^ OTH Insurance
Jil Stark ~ IND
1/23/01 1679 Tulane Road ^ COM Retired 100.00
Claremont, CA 91711 ^ OTH
Gail Stout BIND Assistant Manager,
1/23/01 1407 Foothill Boulevard, Suite 51 ^ COM Remax Masters Real 100.00
La Verne, CA 91750 ^ OTH Estate
Susan Haffey ®IND Homemaker
1/25/01 2101 Garfield ^ COM 100.00
Anaconda, MT 59711 ^ OTH
Lidia Mohan ®IND
1/27/01 3825 Newark Court ^ COM Homemaker 100.00
Claremont, CA 91711 ^ OTH
William Baker ]IND William M. Baker,
1/30/01 488 West 6th Street ^ COM Attorney at Law 100.00
Claremont, CA 91711 ^ OTH
SUBTOTAL $ 599.00 ~ •`~'"~
~~
'Contributor Codes
IND -Individual
COM - Reaplent Committee
OTH -Other
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
•
•
Schedule A (Continuation Sheet)
7)rpe or print In Ink
SCHEDULE A (CONT.)
Monetary Contributions Received Amounts may oe rounaea Statement covers period
"
to whole dollars. •
~ '
~
from 1 21/01 •"
through 2/17/01 page ~ of 1~
NAME OF FILER I.D. NUMBER
Bernard D. Bollinger, Jr./Bo Bollinger for City Council Not yet received
DATE FULL NAME, MAILING ADDRESS AND ZIP CODE OF CONTRIBUTOR
F CONTRIBUTOR IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER AMOUNT
RECEIVED THIS CUMULATIVE TO DATE
CALENDAR YEAR CUMULATIVE TO DATE
OTHER
RECEIVED (I
COMMITTEE, ALSO ENTER I.D. NUMBER) *
CODE (IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
PERIOD
(JAN 1 -DEC 31)
(IF APPLICABLE)
Margaret Tavaglione ®IND
2/2/01 2805 Kathleen Street ^ COM Retired
100.00
Riverside, CA 92506 ^ OTH
Marilynne Belna ®IND Attorney, Los
2/3/01 1402 Lafayette Road ^ COM Angeles County 100.00
Claremont, CA 91711 ^ OTH District Attorney
Stuart Buchalter ^IND Attorney, Buchalte
2/3/01 601 S. Figueroa Street, Suite 2400 ^ COM etc. and Escondido 100.00
Los Angeles, CA 90017 ®OTH Resources Ltd.
Richard Goldstein ®IND Attorney, Buchalte ,
2/3/01 13317 Westcove Drive ^ COM Nem•`r, Field:; S:
250.00
Los Angeles, CA 90049 p
OTH ~
Youn~ er
Robert Bowcock ®IND Consultant,
2/4/01 2417 N. Bonnie Brae Avenue ^ COM Integrated Resourc 1.00.00
Claremont, CA 91711 ^ OTH Management, Inc.
John Kane ^IND CEO, Visual
2/5/01 p.0. Box 550 ^ COM Information
100.00
Claremont, CA 91711 ®OTH Systems Co.
SUBTOTAL $ 750
00 «>.. ,.., ~4.:
''-`"
. • aa, 7T
'Contributor Codes
IND -Individual
COM - Reapient Committee
OTIi -Other
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5660
•
•
Schedule A (Continuation Sheet)
Type or print In Ink
SCHEDULE A (CONT.)
Monetary Contributions Received amounts may oe rounaea Statement covers period • . ,
to whole dollars. ~ • '
from 1/21/01 •
through 2/17/01 page 7 of 10
NAME OF FILER I.D. NUMBER
Bernard D. Bollinger, Jr./Bo Bollinger for City Council Not yet received
DATE
FULL NAME, MAILING ADDRESS AND 21P CODE OF CONTRIBUTOR
CONTRIBUTOR IFAN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER AMOUNT
RECEIVED THIS CUMULATIVE TO DATE
CALENDAR YEAR CUMULATIVE TO DATE
OTHER
RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
PERIOD
(SAN 1 -DEC 31)
(IF APPLICABLE)
Roberta Cicero ^IND Draftsman,
2/6/01 2027 S. Waverly Drive ^ COM icero Drafting 100.00
Anaheim, CA 92802 ® OTH
Jeff Stark ®IND Investment Advisor
2295 Freeman ^ COM Fukagawa Stark & 100
00
2/7/01
Claremont, CA 9111
^ OTH
Associates . .
Christine Limon ®IND Sales,
2/8/01 641 Hood Drive ^ COM Gambro
100
00
Claremont, CA 91711 ^ OTH .
Louis Brutocao ^IND Owner
2/13/01 p,0. Box 2010 ^ COM Rai-Bear, Inc. 250.00
Covina, CA 91722 ® OTH
John Renken ^IND Commercial Apprais r=
2/13/01 2120 Foothill Boulevard, Suite 204 ^ COM The Renken Company 100.00
La Verne, CA 91750 ® OTH
Judy and Colin Wright ^IND Community Historia ,
2/13/01 472 West 10th Street ^ COM Claremont Historic 100.00
Claremont, CA 91711 ® OTH Resources;
Professor, CMC
SUBTOTAL $ 750.00 ..:...
,.;
'Contributor Codes
IND -Individual
COM -Recipient Committee
OTH -Other
FPPC Form 460 (8/99)
For Technical Assistance: 916/322-5680
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Type or print In Ink.
Amounts maybe rounded
to whole dollars.
NAME OF FILER
Bernard D. Bollinger, Jr./Bo Bollinger for City Council
Statement covers period
from 1/21/01
through 2/17/01
Page ~- of .~_
I.D. NUMBER
Not received
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalla/Msc.
CNS campaign consultants
CTB contribution (explain ranmonetary)'
• CVC avlc donatbns
FND fundraising events
IND independent expenditure supporting/opposing others (explain)'
LIT campaign literature and mailings
MTG meetings and appearances
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF CDMMn~ AL40 ENTEA I.D. NUMBER)
OFC office expenses
PET petition dreulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airtime and production cosh
CODE OR
RFD returned contributions
SAL campaign workers salaries
TEL t.v. or cable alrtlme and produdion costs
TRC candidate travel, lodging and meals (explain)
TRS stafUspouse travel, lodging and meals (explain)
TSF transfer between committees of the same candidate/sponsor
VOT voterregistration
WEB information technology costs (Internet, a-mall)
DESCRIPTION OF PAYMENT
AMOUNT PAID
U. S. Post Office
140 Harvard Avenue POS 125.80
Claremont, CA 91711
A&M Direct Mail Service, Inc.
949 N. Cataract Avenue, Unit I/P.O. Box 216 LIT 964.35
San Dimas, CA 91773
• Claremont Courier
111 S. College Avenue PRT
Claremont, CA 91711
'Payments that are contributlona or Independent expenditures must also be summarized on Schedule D.
784.80
SUBTOTALS 1, 874.95
Schedule E Summary
1. Payments made this period of $100 or more. (Include all Schedule E subtotals.) ............................................................................................... $ 3 , 082.84
2. Unitemized payments made this period of under $100 ........................................................................................................................................ $ 26.24
3: Total. interest paid this period on outstanding loans. (Enter amount from Schedule B, Part 2, Column (d).) ....................................................... $
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ......................... TOTAL $ 3,109.08
FPPC Form 460 (8/99)
For Technical Assistance: 916/322660
Schedule E
(Continuation Sheet)
Payments Made
Type or print in Ink.
Amounts may be rounded
to whole dollars.
NAME OF FILER
'Bernard D. Bollinger, Jr./Bo Bollinger for City Council
Statement covers period
SCHEDULE E (CONT.)
from 1 /21/01
through 2/17/01
Page ~ of 1Q-
I.D.NUMBER
Not yet receive d
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc. OFC office expenses RFD returned contributlons
CNS campaign consultants PET petition dreulating SAL campaign workers salaries
CTB contribution (explain nonmonetary)' PHO phone banks TEL t.v. orcable airtime and production costs
CVC civic donations POL polling and survey research TRC candidate travel, lodging and meals (explain)
• FND fundraising events POS postage, delivery and messenger services TRS staff/spouse travel, lodging and meals (explain)
IND independent expenditure supporting/opposing others (explain)' PRO professional services (Iegai, accounting) TSF transfer between committees of the same gndidate/sponsor
LIT campaign literature and mailings PRT print ads VOT voter registration
MTG meetings and appearances RAD radio airtime and production costs WEB information technology costs (intemet, a-mail)
•
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE, ALSO ENTER LD. NUMBER) _ CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Mindy Teuber Reimbursement of expenses
11368 Windhaven Court
LiT See Schedule G for vendors
1,007.89
Alta Loma, CA 91701 receiving $100 or more
Jennifer Seekell
P.O. Box 1007 LIT 200.00
Graeagle, CA 96103
'Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1 , 207.89
FPPC Form 460 (6/99)
ForTechnlcalAssistance: 916/322-5660
Schedule G Type or print In Ink.
Payments Made by an Agent or Independent Amountamayberounded
Contractor (on Behalf of This Committee) towhcledollaro.
SEE INSTRUCTIONS ON REVERSE
NAME OF FlLER
Bernard D. Bollinger, Jr./Bo Bollinger for City Council
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Tauber
Not yet received
CODES:. If one of the following codes accurately describes the payment, you may enter the code . Otherwise, describe the payment.
CMP campaign paraphemalia/rrmisa OFC offtoe expenses RFD returned contributlons
CNS campaign consultants PET petltlon drlaAatlng SAL campaign workers salaries
CTB conhibutlon (explain nonnmonetary)' PHO phone banks TEL Lv. or cable ainime and produdtion costs
~CVC dvic donatkmns POL polling and survey research TRC candidate travel, lodging and meals (explain)
FND fundraising events POS postage, delivery and messenger services TRS statUspouse travel, lodging and meals (explain)
IND Independent expendriure supporting/opposing others (explain)' PRO professkxmal seMces (legal, accounting) TS F transfer between committees of the same candidate/sponsor
UT campaign IRerature and mailings PRT print ads VOT voter registratlon
MTG meetings and appearances RAD redo airtime and production costs WEB information tech casts
nology (lrttemet, a-mail)
' Payments that aro contributions or Independent expenditures must also be summarized on Schedule D.
NAME AND ADDRESS OF PAYEE OR CREDITOR
QFCOMMrmTEE. ALSO ENTER I.D. NVMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Sir Speedy Printing Center
8628 Utica Avenue, Suite 700
Rancho Cucamonga, CA 91730
LIT 704.64
Daily Bulletin
2041 E. Fourth Street-
Ontario, CA
PRT
106.50
covers
from 1 21/01
EDULE G
through 2/17/01 I paw 10 of 10
I.D. NUMBER
Attach addiliona/information on appropria~e/y/abe%d continua/ion sheets TOTAL• $ g 11.14
~b~onorrran~rmenyoCA9is~ob~eorroB,l~sufiinaryoeyl~. rn~srom~maynorequa~a,~eeinarerp~Hrod~eeyenror/nryeperaranrcmorbaclla• FFPC Fonn aso (ergs)
es ieooiredon Sa~iedure E
For Teehnlcai Assistance: 91 Br322~680