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2012District2Ortiz
OFFICE USE ONLY STATEMENT OF CANDIDATE (Section 106.023, F.S.) (Please Type) 2011 JAN 31 PM 3:59 41J1mi(7o L. 02-77:3 O o^l candidate for the office of ect,./..- ,..NotowirA .17 have received, read and understand the requirements of Chapter 106, Florida Statutes. // ate Each candidate must file a statement with the qualifying officer within 10 Appointment of Campaign Treasurer and Designation of Campaign Depository failure to file this form is a first degree misdemeanor and a civil violation of Financing Act which may result in a fine of up to $1,000, (ss. 106.19(1)(c), 106. Statutes). days after the is filed. Willful the Campaign 265(1), Florida DS -DE 84 (Rev. 03/08) APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY FOR CANDIDATES (Section 106.021(1), F.S.) (PLEASE PRINT OR TYPE) NOTE: This form must be on file with the qualifying officer before opening the campaign account. 2011 JAN 31 PM 3:59 OFFICE USE ONLY 1. CHECK APPROPRIATE BOX(ES): ❑ Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy ❑ Depository ❑ Office ❑ Party 2. N e of Candidate (in this order: First, Middle, Last) /ice?a i/ii'?l1r5�7�it6%O [ �.Q?�/T 3. Address (include post o ice or street, city, state, zip code) / /�OZ./ /�ea`-t e "Y 0 /r A Alt -3 4. Telephone 5. E-mail address 6.0 ice sought (include district, circuit,stooup number) /eb,.. „44,SsibA a applicable: ? DA 0iQG i.5-7: 2- � 1� d 7. If a candidate for a non artisan office, check if ❑ My intent is to run as a Write -In candidate. 8. If a candidate for a partisan office, check block and fill in name of party as applicable: My intent is to run as a ❑ Write -In FA No Party Affiliation Party candidate. 9. I have appointed the following person to act as my El Campaign Treasurer ❑ Deputy Treasurer 10. Name of T asurer or Deputy • reas�ar • A �`A/�✓` 11. Mailing Addre ,,, // /'6,2-/ £ ��4//1 6J7 cC t 12. Telephone ( ) 1 y /1 cA��a 1 .c1rc ounty 15. tate 16. Zip Code AZ303 17.kmail 17. mail adress �� T K . a©.-1 18. I have designated the following bank as my N Primary Depository ❑ Secondary Depository 19/Name of Bank /"H!2- l.J ?Afar 0gee i7 (�ti o 20. Address 21. ty �-L4-, � 0 22. 1�xic6� 23. State/ 24. z Codeti 7 UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FA S STATED IN IT ARE UE. 25. Date 3 / 26. Signature .,. •` ,6 ate X /7 ,e, 27. PTreasurer's Accept nce of Appointment (fill in the blankand check the appropriate ,•lock) I, V 0/}A." CA -,e • , do hereby accer - appointment (Please Print or Type Name) designated ab ve as: ❑ Campaign Treasurer Deputy Treasurer. Date SI nat re of Campaign Treasurer or Deputy Treasurer -DE 9 (Rev. 10/10) Rule 1S-2.0001, F.A.C. FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Tony Ortiz OFFICE USE ONLY 2o ;"N Name (2) 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): 12 Candidate (office sought): Commissioner District (3) ID Number: 2 ❑ Political Committee ■ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED -1714PaKrtiecutive Committee ❑ Electioneering Communication • CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From o1 / 01 / ii To 03 / 31 / 11 Report Type Q1 Report ❑ Independent Expenditure Report lI Original ❑ Amendment ❑ Special Election (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 500.00 (7) Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT $ 0.00 Loans $ 1,000.00 to Office $ Total Monetary $ 1,500.00 $ 0.00 In -Kind $ (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date $ 500.00 (10) TOTAL Monetary Expenditures To Date $ 0.00 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete. (Type name) John M Carr I certify that I have examined this report and it is true, correct, and complete. (Type name) Tony Ortiz ❑✓ Individual (onl for ✓❑Treasurer III Deputy Treasurer ✓ Can id a hairperson (only for C, PTY & el commun. o electioneerin± m un.) X .. • X ctioneering anization) Signature Signa ure DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Tony Ortiz- Campaign District 2 (2) I.D. Number (3) Cover Period 01 / 01 / 2011 through 03 / 31 / 2011 (4) Pa e 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03 / 15 /2011 Better Business Services, Inc 1621 Hillcrest St, Orlando, FL 32803 B Taxprepa ration CHE 500.00 1 I I I 1 I 1 I I I 1 I 1 DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES CAMPAIGN TREASURER'S REPORT — ITEMIZED CONTRIBUTIONS (1) Name Tony Ortiz- Campaign District 2 (2) I.D. Number (3) Cover Period 01 / 01 / 2011 through 03 / 31 / 2011 4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number / / 0.00 / / / / / / / / / / / / / / DS -DE 13 (Rev. 08/03) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) .DYi() 0 ) '►'-7Z, or k oiiEv : 16 6 201 I JUL I p4 4:16 Name .,J (2) 1621 E Hillcrest Address (number and street) Orlando, Florida 32803 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): Commissioner District (3) ID Number: 2 P4 Candidate (office sought): ❑ Political Committee ❑ Committee of Continuous Existence ❑ Party Executive Committee ❑ Electioneering Communication ❑ CHECK IF PC HAS DISBANDED IF CCE HAS DISBANDED IF NO OTHER ELECTIONEERING REPORTS WILL BE FILED • CHECK ❑ CHECK COMMUNICATION (5) REPORT IDENTIFIERS Cover Period: From 01 / 0 i/ 91 To 0-. / 3i / h Report Type Q I Amendment ❑ Special Election Report ❑ Independent Expenditure Report • Original (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 5 CD, 00 (7) Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT $ 0.0 c Loans $ ( 000, 00 to Office $ 0.00 Total Monetary $ 15 0C). 00 $ • 0.0 G In -Kind $ 0.0 0 (8) Other Distributions $ 0.00 (9) TOTAL Monetary Contributions To Date $ i 00.00 (10) TOTAL Monetary Expenditures To Date $ C.0 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete. (Type name) John M Carr I certify that I have examined this report and it is true, correct, and complete. (Type name) Tony Orti 0 Individual (only for ✓ Treasurer ❑ Deputy Treasurer ✓ Can 'd a Chairperson (only r PC, PTY & I2ctioneering commun. prganization) electioneer' 1g co mun.) X k.J1/4.-- X Signat Signat re DS -DE 12 (Rev. 08/04) CAMPAIGN TREAbURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 01/01/2011 - 03/31/2011 (2) I.D. Number 00000 (4) Page 1 of 1 (t) Date (7) Full Name (Last, Suffix, First, Middle) Street Address a City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (1 p) In -kind Description (11) mendment (12) Amount (6r— Sequence Number 03/15/2011 Better Business Services Inc 1621 E Hillcrest Street Orlando, FL 32803-0000 B Accounta nt CAS $ 500.00 1 03/15/2011 Ortiz, Ton Orlando, FLi0000 I Comissio ner LOA $ 1000.00 2 r This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, k - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 01/01/2011 - 03/31/2011 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) (2) (4) Check X Antonio Ortiz OFFICE USE ONLY _ . Name 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code (3) I.D. Number. 00000 Political Committee Check if PC has DISBANDED Cover Li (5) REPORT IDENTIFIERS Period: From 01/01/2011 To 03/31/2011 Report Type* Q1 Original LJ Amendment Special Election Report Independent Expenditure Report Cash Loans Total In -Kind (6) CONTRIBUTIONS THIS REPORT & Checks $500.00 Monetary Expenditures Transfers Account Total (7) EXPENDITURES THIS REPORT $0.00 $1,000.00 to Office $0.00 Monetary $1,500.00 Monetary $0.00 $0.00 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date $ 1,500.00 (10) TOTAL Monetary Expenditures to Date $0.00 (11) CERT FICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) 1 certify that I have examined this report and it is true, correct and complete John M Carr I certify true, that I have examined this report and it is correct and complete Tony rtiz X I Individual (only for Chairmen Can X ((illy for PC. $ eledionearim 9 commun. anizagun) Signature Signet e This form is based on DS DE 12 (Rev. 08104) oflwsre, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED L ONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 01/01/2011 - 03/31/2011 2012 (2) 1.0. Number 00000 (4) Page 1 of (5) Date (7) Full Name Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (1 1) Amendment — (12) Amount (6) Sequence Cum, suffix, Frat, Middle) City, Stets, C« 03/15/2011 Better Business Services Inc 1621 E Hillcrest Street Orlando, FL 32803-0000 B Accounts nt CHE UPD $ 500.00 1 03/15/2011 Ortiz, Tony rlando, FL 0 I Comissio ner LOA UPD $ 1000.00 2 This form is based on OS -DE 13 (Rev. 08/03) Adjutant Sottwa., Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) 1')�l�`U n I Q '' Vly �� nY-t-� Z OFFICE USE ONLY 2011 jUL 7 Pi4 4:16 , Name (2) 1521 E Hillcrest Address (number and street) Orlando, Florida 32803 City, State, Zip Code • CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): P3 Candidate (office sought): Commissioner District (3) ID Number: 2 ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED Party Executive Committee . ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From / 01 / J l To Q (p / 50 / 1/ Report Type Gsca Report ❑ Independent Expenditure Report Original ❑ Amendment ■ Special Election (6) CONTRIBUTIONS THIS REPORT Cash & Checks $ 1-150D D0 (7) Monetary Expenditures Transfers Account Total Monetary EXPENDITURES THIS REPORT $ (C9(OLi. g9 Loans $ 0.6o to Office $ 0.00 Total Monetary $ 145O , 00 $ /6)&4 . QP In -Kind $ 0.00 (8) Other Distributions ,,, $ :r>'_ a 0 (9) TOTAL Monetary Contributions To Date $ 690.00 .00 (10) TOTAL Monetary Expenditures To Date $ f (olp,-1 , 39 , (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete_ (Type name) John M Carr I certify that I have examined this report and it is true, correct, and complete. (Type name) Tony Ortiz 0 Individual (only for ✓ Treasurer IIDeputy Treasurer ✓ Candi t ❑ airperson (only for P , PTY & el loneering commun. org ization) electionee ' g mun.) X &" Gri.ar X Sign Signet e DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 04/01/2011 - 06/30/2011 (2) I,D. Number 00000 (4) Page 1 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 06/07/2011 Hadley, Robert 1257 Americana Place Orlando, FL 32807-0000 I Retired CHE $ 100.00 1 06/07/2011 Matassa, Mary Jean 6205 Shenandoah Way Orlando, FL 32807 0000 I Retired CHE $ 25.00 2 06/07/2011 Lockman, Richard 58 S Solandra Dr Orlando, FL 32807-0000 1 Retired- Deputy Sherrif CHE $ 50.00 3 06/09/2011 Mercado, Luis 204 Chelsea Ave Orlando, FL 33837-0000 I Marketing CHE $ 100.00 4 06/09/2011 LeDuc, Donald & Audrey 1209 Melissa Ave Orlando, FL 32807-0000 1 Retired CHE $ 50.00 5 ,r,' 0811 11:: Adams, Louis & Nina 4400 Cranston Place Orlando, FL 32812-0000 1 Retired P $150,00 6 06/17/2011 Mercado, Josephine 230 Carriage Hill Drive Casselberry, FL 32707-0000 I Executive Director CHE $ 50.00 7 06/17/2011 Cardoos, Louella & Sonia 3488 Clear Stream Orlando, FL 32822-0000 1 Retired CHE $ 100.00 8 This form is based on DS -DE 13 (Rev. 08103) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 04/01/2011 - 06/30/2011 (2) I.D. Number 00000 (4) Page 2 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 06/21/2011 Aviles, Gilberto I Retired CHE $ 25.00 5950 Villaghe Circle North Orlando, FL 32822-0000 9 06/21/2011 Ramirez, Alicia & Samuel I Business CHE $ 50.00 741 Little Wekiva Circle Owner Altamonte Springs FL 32714-0000 10 06/21/2011 Premier Distribution Incorporated B Business CHE $ 50,00 PO Box 160097 Altamonte Springs, FL 32716-0000 11 06/28/2011 Wagner Pod, Virginia I Retired CHE $ 150.00 717 Kankakee Lane Orlando, FL 32807-0000 12 06/28/2011 Swann, Debra I Unknown CHE $ 20.00 612 S Oxalis Ave Orlando, FL 32807-0000 13 t Alit; &'Ann' ,1 Retired CHE ° ` . . . $100:00:.. 3806 Running Deer Drive Orlando, FL 32829-0000 14 06/30/2011 Cohen, Kelly 1 Attorney CHE $ 500.00 100 S Eola Drive Apt 607 Orlando, FL 32801-0000 15 06/30/2011 Thomas P. Callan, P.A. B Attorney CHE $ 500.00 921 Bradshaw Terrace Orlando, FL 32806-0000 16 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 04/01/2011 - 06/30/2011 (2) I.D. Number 00000 (4) Page 3 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 08/30/2011 Y & J Enterprises LLC 921 Bradshaw Terrace Orlando, FL 32806-0000 B Attomey CHE $ 500.00 17 06/30/2011 City Cab Company of Orlando Inc PO Box 3227 Orlando, FL 32802-0000 B Transport ation CHE $ 500.00 18 06/30/2011 Mears Destination Services Inc PO Box 3227 Orlando, FL 32802-0000 B Transport ation CHE $ 500.00 19 06/30/2011 Dykes, Everett & Company Inc 822 West Central Blvd Orlando, FL 32805-0000 B Consultin g Services CHE $ 500.00 20 06/30/2011 Melix Corporation 9350 Conroy Windermere Road Orlando, FL 34786-0000 B Real Estate CHE $ 500.00 21 This form is based on DS -DE 13 (Rev 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 04/01/2011 - 06/30/2011 (2) I.D. Number 00000 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 04/11/2011 Suntrust Merchant Account Monthly Service Fee MON $ 113.95 2300 East Colonial Drive Orlando, FL 32803-0000 1 05/09/2011 Better Business Services Inc Postage MON $ 88.00 1621 E Hillcrest Street Orlando, FL 32803 0000 .. ^?..` pq p y� y ..qa 2 05/10/2011 Suntrust Merchant Account Monthly Service Fee MON $ 145.39 2300 East Colonial Drive Orlando, FL 32803-0000 3 05/10/2011 Royal Press Campaign MON $ 406.60 973 W State Road 434 Letterhead/Envelopes Longwood, FL 32750-0000 4 05/13/2011 Better Business Services Inc Bookkeeping MON $ 250.00 1621 E Hillcrest Street Orlando, FL 32803-0000 5 'AllirW 4, BOW'Business Setvicosilft ` 1821 E Hillcrest Street v. ,0 [!"x0110 .: M ::''. � -. $�� ,� $ 8800 • Orlando, FL 32803-0000 6 05/25/2011 Adjutant Software Inc Campaign ToolBox MON $ 140.00 2055 Bond Road Software DeLand, FL 32720-0000 7 05/31/2011 Suntrust Bank 3517 Bank Charges MON $ 10.00 2300 East Colonial Drive Orlando, FL 32803-0000 8 This form Is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox s. CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 04/01/2011 - 06/30/2011 (2) I.D. Number 00000 4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add oTfice sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 06/10/2011 Suntrust Merchant Account 2300 East Colonial Drive Orlando, FL 32803-0000 Bank Charges MON $ 39.95 9 06/10/2011 Better Business Services Inc 1621 E Hillcrest Street Orlando, FL ?2803-0000 ,. .,. , t-' Bookkeeping - - MON — $ 250.00 Z rr 10 06/14/2011 Better Business Services Inc 1621 E Hillcrest Street Orlando, FL 32803-0000 Postage MON $ 88.00 11 06/22/2011 Deluxe Check PO Box 622227 Orlando, FL 32862-0000 Deposit Slips MON $ 35.00 12 06/30/2011 Suntrust Bank 3517 2300 East Colonial Drive Orlando, FL 32803-0000 Monthly Maintenance Fee MON $ 10.00 13 .'=1- = This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) rI V J vJ i C " 11) 9 t' i Y`i2 OFFICE USE ONLY Name (2) 1621 E Hillcrest r r 0 :a , 'y; Address (number and street) Orlando, Florida 32803 City, State, Zip Code ❑ CHECK IF ADDRESS HAS CHANGED (3) ID Number: (4) Check appropriate box(es): Candidate (office sought): Commissioner District 2 ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence • CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Cover Period: From(' / 0 / i To Di / ',?-k / \ \ Report Type Q 2) 1 Original ❑ Amendment ❑ Special Election Report ❑ Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT �► Cash & Checks $ \5+ •"C1 , a U (7) EXPENDITURES THIS REPORT Monetary Expenditures $ qe0 , 1 1( Transfers to Office Account $ 0 Loans $ U) !!`"' Total Monetary $ \ k C5. C)O Total Monetary $ <6P ( 4' In -Kind $0 (8) Other Distributions J' $ (yT� (9) TOTAL Monetaryon Contributions To Date $ 1--t on A p I (10) TOTAL Monetary Expenditures To Date $ i 1c7, • (1)0 t74CAS (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete. (Type name) John M Carr I certify that I have examined this report and it is true, correct, and complete. (Type name) Tony Ortiz ✓ electio X Individual (only for erin commun.) A .�0o�.r ✓ Treasurer ❑ Deputy Treasurer ❑✓ Cat 'dat Chairp on lectioneering (only for PC, PTY & mmun. organization) Sig re Sign ure DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 1 of 6 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 07/08/2011 Cepero, Angel & Martha 9516 Queensbury Court Windermere, FL 34786-0000 I Accounta nt CHE $ 300.00 1 07/13/2011 Kantor, Hal 815 Cordova Drive Orlando, FL 32804-0000 I Attomey CHE $ 500.00 2 07/13/2011 WBQ Design & Engineering Inc 201 N Magnolia Ave Suite 200 Orlando, FL 32801-0000 B Civil Engineer s CHE $ 200.00 3 07/15/2011 Orlando Professional Firefighters Local 1365 4005 N Orange Blossom Trail Orlando, FL 32804-0000 B Firefighte rs CHE $ 500.00 4 07/18/2011 Airborne Security Services Inc PO Box 191794 San Juan, PR 00919-0000 B Security CHE $ 500.00 5 07/18/2011 Skiles, Allyson 2220 Treymore Drive Orlando, FL 32825-0000 I Police Officer CHE $ 100.00 6 07/20/2011 Pugh Jr., James 359 Carolina Avenue Suite #200 Winter Park, FL 32789-0000 1 Real Estate Develope r CHE $ 500.00 7 07/21/2011 Glass, Scott & Kathie 2417 Ridgewind Way Windermere, FL 34786-0000 I Attorney CHE $ 100.00 8 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 2 of 6 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In kind Description (11) Amendment (12) Amount (6) Sequence Number 07/21/2011 Saavedra, Oswald 9814 Mohrs Cove Lane Windermere, FL 34786-0000 I Physician CHE $ 500.00 9 07/21/2011 Shutts & Bowen LLP 1500 Miami Center- 201 Biscayne Blvd Miami, FL 33131-0000 B Attorney CHE $ 500.00 10 07/21/2011 Willard, James & Carol 228 West 7th Avenue Windermere, FL 34786-0000 I Attorney CHE $ 250.00 11 07/21/2011 Zucker, Steven & Linda 1238 Scandia Terrace Oviedo, FL 32765-0000 I Attorney CHE $ 100.00 12 07/22/2011 618 East South Street LLC 801 N Orange Ave Suite 530 Orlando, FL 32801-0000 B Develope r CHE $ 500.00 13 07/26/2011 Trabold, Frederick & Blanca 900 Old England Avenue Winter Park, FL 32789-0000 I Retired CHE $ 200.00 14 07/26/2011 Event Event Productions Inc 1930 Commerce Oak Avenue Orlando, FL 32808-0000 B Productio ns CHE $ 500.00 15 07/26/2011 World Wide Event Productions Inc 1930 Commerce Oak Avenue Orlando, FL 32808-0000 B Productio ns CHE $ 500.00 16 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign Tooleox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I,D. Number 00000 (4) Page 3 of 6 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 07/26/2011 Complete Productions Resources Inc 1930 Commerce Oak Avenue Orlando, FL 32808-0000 B Productio ns CHE $ 500.00 17 07/26/2011 Brinklet Productions Inc 578 N Orange Avenue Orlando, FL 32801-0000 B Productio ns CHE $ 500.00 18 07/26/2011 Harrold Productions Inc 578 N Orange Avenue Orlando, FL 32801-0000 B Productio ns CHE $ 500.00 19 07/26/2011 All In One Productions Inc 578 N Orange Avenue Orlando, FL 32801-0000 B Productio ns CHE $ 500.00 20 08/08/2011 Sullivan Properties Inc 130 S Orange Avenue #202 Orlando, FL 32801-0000 B Real Estate Develope r CHE $ 500.00 21 08/08/2011 Kress Building, LLC 130 S Orange Avenue #202 Orlando, FL 32801-0000 B Real Estate Develope r CHE $ 500.00 22 08/16/2011 Oberly, Mr., Evan 4530 Loring Place Orlando, FL 32812-0000 I Applianc e Repair Man CHE $ 50.00 23 08/16/2011 Knowles, ., James 5041 Doretta Ct Orlandoo, FL 32807-0000 1 Retired CHE $ 100.00 24 This foml is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 4 of 6 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 08/24/2011 Philippone, Frank 6401 Pinewood Dr. Orlando, FL 32822-0000 1 Real Estate CHE $ 50.00 25 08/24/2011 Soulard, Lou 3202 Candleridge Dr. Orlando, FL 32822-0000 I Retired CHE $ 25.00 26 08/24/2011 Cassar, Betty 619 Oxalis Orlando, FL 32807-0000 1 Unemplo yed CHE $ 100.00 27 09/22/2011 Opsahl, Robert & Muriel 6463 Pinewood Drive Orlando, FL 32822-0000 1 Retired CHE $ 100.00 28 09/26/2011 Brown II, David C. 390 N. Orange Ave Suite 1400 Orlando, FL 32801-0000 I Real Estate CHE $ 250.00 29 09/26/2011 Chandler, Thomas & Peggy 3331 Lakeview Oaks Dr Longwood, FL 32779-0000 I Architect CHE $ 500.00 30 09/26/2011 Graham, Keith & Jolynn A. PO Box 339 Killarney, FL 34740-0339 I Lawyer CHE $ 250.00 31 09/26/2011 Marchena, Nancy & Marcos 8535 Chickasaw Farms Lane Orlando, FL 32825-0000 I Lawyer CHE $ 500.00 32 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 5 of 6 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 09/26/2011 Rey, Jose & Isabel 8527 Chickasaw Farms Lane Orlando, FL 32825-0000 I Contract° r CHE $ 100.00 33 09/26/2011 Rodon, George & Rene M. 4866 Berrywood Drive Orlando, FL 32812-0000 I Retired CHE $ 200.00 34 09/26/2011 Verde Construction Managers, LLC 976 Lake Baldwin Lane Suite 201 Orlando, FL 32814-0000 B Construct ion CHE $ 250.00 35 09/26/2011 Sheltair Orlando Air Center, Inc 321 N. Crystal Lake Dr Orlando, FL 32803-0000 B Aviation CHE $ 500.00 36 09/26/2011 Orlando L. Evora 450 South Orange Ave Suite 650 Orlando, FL 32804-0000 B Lawyer CHE $ 500.00 37 09/26/2011 Marchena and Graham, PA 976 Lake Baldwin Lane Suit 101 Orlando, FL 32814-0000 B Lawyer CHE $ 500.00 38 09/26/2011 Hartford Air & Marine Services LLC PO Box 533993 Orlando, FL 32853-0000 B Consultin g CHE $ 500.00 39 09/26/2011 E. Gonzalez -Chavez, Architect 976 Lake Baldwing Lane Suite 202, 629-1117 Orlando, FL 32814-0000 B Architect CHE $ 100.00 40 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 6 of 6 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, state, zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 09/26/2011 Consensus Communications, Inc 605 E. Robinson Street Suite 750 Orlando, FL 32801-0000 B Public Relations CHE $ 500.00 41 09/26/2011 Consensus Public Relations LLC 605 E. Robinson Street Suite 750 Orlando, FL 32801-0000 B Public Relations CHE $ 500.00 42 09/26/2011 Centurion Equity, Inc 390 N. Orange Ave Suite 1400 Orlando, FL 32801-0000 B Real Estate CHE $ 250.00 43 09/26/2011 Christmas Creek Ranch LLC PO Box 533993 Orlando, FL 32853-0000 B Consultin g CHE $ 500.00 44 09/26/2011 A2 Group Inc PO Box 432310 S. Miami, FL 33243-0000 B Engineeri rig & Construct . Mgmt CHE $ 500.00 45 09/28/2011 Casiano, Manuel & Nora 2007 Magnolia Street San Juan, PR 00915-0000 I Publisher CHE $ 200.00 46 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 07/22/2011 Studio Pacific Logo Campaign Logo MON $ 400.00 5411 47th Avenue Southwest Seattle, WA 98136-0000 1 08/03/2011 Suntrust Merchant Account Refund Merchant Fee MON $ -39.95 2300 East Colonial Drive Orlando, FL 32803-0000 2 08/03/2011 Suntrust Merchant Account Refund Merchant Fee MON $ -113.95 2300 East Colonial Drive Orlando, FL 32803-0000 3 08/03/2011 Suntrust Merchant Account Refund Merchant Fee MON $ -145.39 2300 East Colonial Drive Orlando, FL 32803-0000 4 08/09/2011 Better Business Services Inc Bookkeeping Services MON $ 250.00 1621 E Hillcrest Street Orlando, FL 32803-0000 5 08/25/2011 Better Business Services Inc Bookkeeping Services MON $ 500.00 1621 E Hillcrest Street Orlando, FL 32803-0000 6 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to report on t its form This form is based on DS -DE 14A (Rev. 08/03) [Note about Committees has been removed.] Adjutant Software, Inc. - Campaign Toolbox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 07/01/2011 - 09/30/2011 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial institution Street Address & City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 94 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) '/ 1)(K) II OrliZ OFFICE USE ONLY ..M711)01C0 Name (2) 1621 E Hillcrest Address (number and street) Orlando, Florida 32803 City, State, Zip Code • CHECK IF ADDRESS HAS CHANGED (4) Check appropriate box(es): ❑/ Candidate (office sought): Commissioner District (3) ID Number: 2 ❑ Political Committee ❑ CHECK IF PC HAS DISBANDED ❑ Committee of Continuous Existence ❑ CHECK IF CCE HAS DISBANDED ❑ Party Executive Committee ❑ Electioneering Communication ❑ CHECK IF NO OTHER ELECTIONEERING COMMUNICATION REPORTS WILL BE FILED (5) REPORT IDENTIFIERS Co r Period: From t / IC:::) / 1 , To t / 3t / t l Report Type L Report ❑ Independent Expenditure Report KV Original ❑ Amendment • Special Election (6) CONTRIBUTIONS THIS REPORT i A Cash & Checks $ ) �� . �� (7) Monetary Expenditures Transfers Account Monetary EXPENDITURES THIS REPORT $ 2 L -t , Loans $ �) to Office $ �" Total Monetary $ 09 r-3Total $ 1 1 2--'-i'.� "� 4" �I , In -Kind $ J2.(13/ (8) Other Distributions 0 (9) TOTAL Monetary Co tributions To Date $ LI i H , �--� (10) TOTAL Monetary Expenditures To Date $ 10, 2140. (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct, and complete. (Type name) John M Carr I certify that I have examined this report and it is true, correct, and complete. (Type name) Tony Ortiz ❑✓ Individual (only for 1 Treasurer II Deputy Treasurer ✓ Candi at ❑ airperson my for PC, PTY & el ctione ring com un. organization) /' electione ing co mun.) X A+"*.. Cyr X Sign Signa re DS -DE 12 (Rev. 08/04) CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 1 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address 8 City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) in -kind Description (11) Amendment (12) Amount (6) Sequence Number 10/04/2011 Hazel, Harold & Mary 599-610 Lake Pointe Orlando, FL 32822-0000 I Retired Engineer & Housewif e CHE $ 75.00 1 10/26/2011 Gray Robinson Attorneys At Law P.O. Box 3068 Orlando, FL 32802-0000 B Attorney CHE $ 500.00 2 10/26/2011 Leonhardt, Fredrick W. 1317 Spring Lake Drive Orlando, FL 32804-0000 1 Attorney CHE $ 250.00 3 10/26/2011 Carmody, Christopher L. 1359 Meetinng Place Orlando, FL 32814-0000 1 Attorney CHE $ 50.00 4 10/26/2011 Sear!, Jason W. 1127 Shorewood Drive Orlando, FL 32806-0000 1 Attorney CHE $ 100.00 5 11/15/2011 Adams, Louis & Nina 4400 Cranston Place Orlando, FL 32812-0000 ! Retired CHE $ 100.00 6 11/15/2011 Golay, Thomas 6471 Mackenzie Street Orlando, FL 32807-0000 I Retired Firefighte r CHE $ 100.00 7 11/18/2011 Thompson, Benjamin Orlando, FL 00000-0000 1 CHE $ 9.45 8 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2)1.0. Number 00000 (4) Page 2 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 11/21/2011 Lee, Gregory D. 200 S. Orange Ave STE 2300 Orlando, FL 32801-0000 I Attorney CHE $ 150.00 9 11/21/2011 CZA, Inc. 1660 Huron Trail Maitland, FL 32751-0000 B Business Develop ment CHE $ 25.00 10 11/21/2011 Orlando Internal Medicine Center, P.A. 1315 S. Orange Ave STE 3-A Orlando, FL 32806-0000 B Physician s CHE $ 500.00 11 11/21/2011 Rural Metro Corp of Florida 4728 Old Winter Garden Rd Orlando, FL 32811-0000 B Ambulan ce Company CHE $ 100.00 12 11/21/2011 Victoria Equities Realty & Management Co. P.O. Box 1911 Orlando, FL 32802-0000 B Manage ment Company CHE $ 250.00 13 11/21/2011 Holland & Knight CCE 315 S. Calhoun St. STE 600 Tallahassee, FL 32301-0000 B Law Firm CHE $ 250.00 14 11/21/2011 One80 Orlando, LLC. 33 W. Church Street Orlando, FL 32801-0000 B Restaura nt/Buildin g Owner CHE $ 500.00 15 11/21/2011 Dirk Bill & Gary IV, Inc. 33 West Church Street Orlando, FL 32801-3301 B Restaura nt/Buildin g Owner CHE $ 500.00 16 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 3 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 11/21/2011 Lee, Wesley & Associates, Inc. 924 N. Magnolia Ave. STE 303 Orlando, FL 32803-0000 B Manage ment Company CHE $ 250.00 17 11/21/2011 U.S. Medical Group P.O. Box 560699 Orlando, FL 32856-0699 B Medical Group CHE $ 500.00 18 11/21/2011 McLeod Properties, Inc. 1112 Sweetbriar Rd Orlando, FL 32806-0000 B Real Estate CHE $ 250.00 19 11/21/2011 Tobin, Larry F. 4501 Old Carriage Trail Oviedo, FL 32765-0000 I Banking CHE $ 250.00 20 11/21/2011 Premier Distribution Incorporated PO Box 160097 Altamonte Springs, FL 32716-0000 B Business CHE $ 125.00 21 11/21/2011 Manglardi, Michael 4181 Gabriella Lane Winter Park, FL 32792-0000 I Attorney CHE $ 500.00 22 11/21/2011 Weatherhold, Louise 6007 Navajo Way Orlando, FL 32807-0000 I Retired CHE $ 200.00 23 11/21/2011 Duggan, James 2615 Oak Park Way Orlando, FL 32822-4196 I Retired CHE $ 25.00 24 This form is based on DS -DE 13 (Rev. 08103) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 4 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address 8 City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 11/21/2011 De Leon, Miguel A. 1361 Gelwood Avenue I Physician s CHE $ 50.00 Orlando, FL 32807-0000 Assistant 25 11/21/2011 Criddle, Patsy J. I Retired CHE $ 100.00 5408 Kalmia Drive Orlando, FL 32807-0000 26 11/21/2011 Owens, Kathryn E. I Retail CHE $ 100.00 5300 Kalmia Drive Orlando, FL 32807-0000 27 11/21/2011 28 11/21/2011 Ortiz, Neslihan I Disabled CHE $ 100.00 7880 Brockwood Circle Orlando, FL 32822-0000 29 11/29/2011 CNL - Banco Latino B Bank CHE $ 100.00 450 S. Orange Ave, STE 180 Orlando, FL 32801-0000 30 11/29/2011 Robert Alfert Jr. PA B Attorney CHE $ 100.00 390 N. Orange Ave, STE 1400 Orlando, FL 32801-0000 31 11/29/2011 Calvet, Cesar E. I Banker CHE $ 100.00 2203 Snow Road Orlando, FL 32814-0000 32 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign Toolbox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 5 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 11/29/2011 Winters, Tom 1405 S. Orange Ave, Suite 601 Orlando, FL 32806-0000 I Doctor INK catering for event $ 500.00 33 11/29/2011 Searl, Jason W. 1127 Shorewood Drive Orlando, FL 32806-0000 1 Attorney INK Food for Event $ 26.47 34 12/05/2011 Epoch Properties, Inc 359 Carolina Ave Suite 200 Winter Pakr, FL 32789-0000 B Real Estate CHE $ 500.00 35 12/06/2011 Harris, John K. 4076 Anthony Lane Orlando, FL 32822-0000 I Citizen Service Coordinat or CHE $ 100.00 36 12/12/2011 Corona Cigar Company 7792 W. Sand Lake Road Orlando, FL 32819-0000 B President & Founder CHE $ 500.00 37 12/19/2011 Frederick, Bill 105 W. New Hampshire Street Orlando, FL 32804-0000 I Lawyer CHE $ 100.00 38 12/19/2011 Premium Funding Inc. 9350 Conroy Windermere Windermere, FL 34786-0000 B Real Estate Investme nt CHE $ 500.00 39 12/19/2011 Windermere Property Development, Inc. P.O. Box 8800 Windermere, FL 34786-0000 B Real Estate Investme nt CHE $ 500.00 40 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 6 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 12/19/2011 Bates, Jason A. 657 Diana Drive Charlotte, NC 28203-0000 I Analyst CHE $ 500.00 41 12/19/2011 Lipsey, Michael J. 2155 Brackenshire Circle Jackson, MS 39211-0000 I Chief Operatin g Officer CHE $ 500.00 42 12/19/2011 Smith, Jeffrey L. 9247 Lake Fischer Blvd. Gotha, FL 34734-0000 I Senior Asset Manager CHE $ 500.00 43 12/19/2011 Gray, Jim 9798 Blandford Rd. Orlando, FL 32827-0000 I Director of Leasing CHE $ 500,00 44 12/19/2011 Bradley, James H. 3333 Middlesex Rd. Orlando, FL 32803-0000 I Executive Admin CHE $ 500.00 45 12/19/2011 O'Reilly, David R. 5001 Latrobe Dr. Windermere, FL 34786-0000 I Chief Investme nt Officer CHE $ 500.00 46 12/19/2011 LoCascio, Lawrence T. 109 Smokerise Blvd. Longwood, FL 32779-0000 I Property Manage ment Director CHE $ 500.00 47 12/19/2011 ACP - Laurich Partnership, LTD 390 N. Orange Ave Suite 2400 Orlando, FL 32801-0000 B Real Estate Investme nt CHE $ 500.00 48 This form is based on DS -DE 13 (Rev. 08103) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 7 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address 8 City, State, Tip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 12/19/2011 Heistand, James R. 390 N. Orange Ave Suite 2400 Orlando, FL 32801-0000 1 Real Estate Professio nal CHE $ 500.00 49 12/19/2011 ACP - JRL Partnership, LTD 390 N. Orange Ave Suite 2400 Orlando, FL 32801-0000 B Real Estate Investme nt CHE $ 500.00 50 12/27/2011 Baker Barrios Architects 189 S. Orange Ave Suite 1700 Orlando, FL 32801-0000 B Architect ure Firm CHE $ 250.00 51 12/27/2011 Kiene, Ford W. P.O. Box 621808 Orlando, FL 32862-1808 I CEO City Beverage s CHE $ 500.00 52 12/27/2011 Hello! Destination Management 3840 Vineland Road Suite 200 Orlando, FL 32811-3763 B Transport ation CHE $ 500.00 53 12/27/2011 Quigley, Jennifer R. P.0, Box 621808 Orlando, FL 32862-1808 1 Engineer CHE $ 500.00 54 12/27/2011 Gallery At Avalong Island LTD P.O. Box 560846 Orlando, FL 32856-0846 B Art Museum CHE $ 500.00 55 12/27/2011 Orlando Magic LTD 8701 Maitland Summit Blvd Orlando, FL 32810-0000 8 Sports & Entertain ment Svcs CHE $ 500.00 56 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 8 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 12/27/2011 WBQ Design & Engineering Inc 201 N Magnolia Ave Suite 200 Orlando, FL 32801-0000 B Civil Engineer s CHE $ 250.00 57 12/27/2011 Property General, Inc. 324 W. Gore Street Orlando, FL 32806-0000 B Transport ation CHE $ 500.00 58 12/27/2011 Hill, Christine P.O. Box 547335 Orlando, FL 32854-7335 1 Marketing CHE $ 200.00 59 12/27/2011 Segal, William 1 Develope r CHE $ 200.00 60 12/27/2011 Bell, Scott D. 738 Hardman Drive Orlando, FL 32806-0000 1 CHE $ 50.00 61 12/27/2011 Kelly, Sarah 548 S. Hampton Ave Orlando, FL 32803-6514 1 Governm ental Affairs CHE $ 100.00 62 12/27/2011 West, Dawn P. 150 E. Robinson St. Unit 1026 Orlando, FL 32801-0000 1 CHE $ 50.00 63 12/27/2011 Finnegan, Troy W. 1806 Nebraska St. Orlando, FL 32803-1922 1 CHE $ 100.00 64 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 9 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (5) Sequence Number 12/27/2011 Legler, Ronald G. 4344 Ilene Court Orlando, FL 32806-0000 I Theatre CHE $ 100.00 65 12/27/2011 Wankelman, Karen W. 4501 New Broad Street Orlando, FL 32814-0000 1 Attorney CHE $ 50.00 66 12/27/2011 Emerge Real Estate Ventures LLC 801 N. Orange Ave STE 530 Orlando, FL 32801-0000 B Real Estate Investme nt CHE $ 100.00 67 12/27/2011 JCB Construction, Inc 800 W. Gore Street Orlando, FL 32805-0000 •B Construct ion CHE $ 100.00 68 12/27/2011 Dowless, Donna R. 1055 Lancaster Drive Orlando, FL 32806-2314 1 Artist CHE $ 100.00 69 12/27/2011 Dillard, Dorcas 2783 Cullens CT Ocoee, FL 34761-0000 1 Real Estate CHE $ 100.00 70 12/27/2011 Hartley, Barbara B. 210 Friar Rd Winter Park, FL 32792-0000 1 CHE $ 50.00 71 12/27/2011 Ustler Group LLC 801 N. Orange Ave STE 530 Orlando, FL 32801-0000 B Real Estate Investme nt CHE $ 100.00 72 This form is based on DS -DE 13 (Rev, 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I,D. Number 00000 (4) Page 10 of 10 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street AddrBes & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 12/27/2011 Atkins -Bradley, Vernice 1049 Petal Ct. Orlando, FL 32818-6922 I Construct ion Manager CHE $ 200.00 73 12/27/2011 Cook, Tom D. 400 E. Colonial Drive STE 510 Orlando, FL 32803-0000 I Real Estate CHE $ 250.00 74 12/27/2011 Massey Services, Inc. 315 Groveland Street Orlando, FL 32804-0000 B Pest Control CHE $ 250.00 75 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 10/11/2011 Better Business Services Inc bookkeeping MON $ 250.00 1621 E Hillcrest Street Orlando, FL 32803-0000 1 10/24/2011 In Touch Strategies, Inc. Consulting MON $ 2500.00 1716 Bobtail Drive Maitland, FL 32751-0000 2 10/24/2011 Pinnacle Global Services, Inc. Business Card Reader MON $ 276,89 1621 E Hillcrest Street Orlando, FL 32803-0000 3 11/17/2011 Guess Photography & Design LLC Photography MON $ 133.13 4415 Fairview Avenue Orlando, FL 32804-0000 4 11/18/2011 Action Mail Services Kick Off Reception MON $ 138.93 1904 Premier Row Orlando, FL 32809-0000 5 11/22/2011 Better Business Svcs (Carr Domain Name/ hosting MON $ 37.17 Consulting) P.O. Box 780637 San Antonio, TX 78278-0000 6 11/22/2011 in Touch Strategies, Inc. Consulting MON $ 2500.00 1716 Bobtail Drive Maitland, FL 32751-0000 7 11/22/2011 Paradise Show & Design Event Stage hand MON $ 280.00 4653 35th Street Orlando, FL 32811-0000 8 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (1 0) Amendment (11) Amount (6) Sequence Number 12/06/2011 Lee Show Services Pipe and Drape for MON $ 245.89 2804 Eastern Parkway Kickoff Event Winter Park, FL 32789-0000 9 12/06/2011 Guess Photography & Design LLC Photography MON $ 291.81 4415 Fairview Avenue Orlando, FL 32804-0000 10 12/16/2011 Royal Press Printing Banner and MON $ 773.51 973 W State Road 434 Labels Longwood, FL 32750-0000 11 12/20/20'11 Royal Press remittance envelopes MON $ 203.87 973 W State Road 434 Longwood, FL 32750-0000 12 12/22/2011 Office Max 1898 S. Semoran Blvd Office Supplies - Ink and Paper MON $ 93.51 Orlando, FL 32822-0000 13 This form is based on DS -DE 14 (Rev. 08)03) Adjutant Software, Inc. - Campaign ToolBox " C A M P A I G N T R E A S U R E R ' S R E P O R T - F U N D T R A N S F E R S ( 1 ) N a m e A n t o n i o O r t i z ( 3 ) C o v e r P e r i o d 1 0 / 0 1 / 2 0 1 1 - 1 2 / 3 1 / 2 0 1 1 ( 2 ) I . D . N u m b e r 0 0 0 0 0 ( 4 ) P a g e 0 o f 0 ( 5 ) D a t e ( 7 ) N a m e o f F i n a n c i a l I n s t i t u t i o n S t r e e t A d d r e s s & C i t y , S t a t e , Z i p C o d e ( 8 ) T r a n s f e r T y p e ( 9 ) N a t u r e o f A c c o u n t ( 1 0 ) A m e n d m e n t ( 1 1 ) A m o u n t ( 6 ) S e q u e n c e N u m b e r N o t h i n g t o r e p o r t o n t h i s f o r m T h i s f o r m i s b a s e d o n D S - D E 9 4 ( R e v , 0 8 / 0 3 ) A d j u t a n t S o f t w a r e , I n c . - C a m p a i g n T o o l B o x " F L O R I D A D E P A R T M E N T O F S T A T E D I V I S I O N O F E L E C T I O N S C A M P A I G N T R E A S U R E R ' S R E P O R T S U M M A R Y ( 1 ) ( 2 ) ( 4 ) L C h e c k X A n t o n i o O r t i z O F F I C E U S E O N L Y _ N a m e 1 6 2 1 E H i l l c r e s t S t A d d r e s s ( n u m b e r a n d s t r e e t ) O r l a n d o , F L 3 2 8 0 3 C i t y , S t a t e , Z i p C o d e ( 3 ) I . D , N u m b e r 0 0 0 0 0 P o l i t i c a l C o m m i t t e e C h e c k i f P C h a s D I S B A N D E D C o m m i t t e e o f C o n t i n u o u s E x i s t e n c e P a r t y E x e c u t i v e C o m m i t t e e C h e c k i f C C E h a s D I S B A N D E D C o v e r L J ( 5 ) R E P O R T I D E N T I F I E R S P e r i o d : F r o m 1 0 / 0 1 / 2 0 1 1 T o 1 2 / 3 1 / 2 0 1 1 R e p o r t T y p e . Q 4 O r i g i n a l j X A m e n d m e n t S p e c i a l E l e c t i o n R e p o r t I n d e p e n d e n t E x p e n d i t u r e R e p o r t C a s h L o a n s T o t a l I n - K i n d ( 6 ) C O N T R I B U T I O N S T H I S R E P O R T & C h e c k s $ 1 9 , 2 0 9 . 4 5 M o n e t a r y E x p e n d i t u r e s T r a n s f e r s A c c o u n t T o t a l ( 7 ) E X P E N D I T U R E S T H I S R E P O R T $ 7 , 7 2 4 . 7 1 $ 0 . 0 0 t o O f f i c e $ 0 . 0 0 M o n e t a r y $ 1 9 , 2 0 9 . 4 5 M o n e t a r y $ 7 , 7 2 4 . 7 1 $ 5 2 6 . 4 7 ( 8 ) O t h e r D i s t r i b u t i o n s $ 0 . 0 0 ( 9 ) T O T A L M o n e t a r y C o n t r i b u t i o n s t o D a t e $ 4 1 , 0 0 4 . 4 5 ( 1 0 ) T O T A L M o n e t a r y E x p e n d i t u r e s t o D a t e $ 1 0 , 2 4 0 . 3 1 ( 1 1 ) C E R T F I C A T I O N I t i s a f i r s t d e g r e e m i s d e m e a n o r f o r a n y p e r s o n t o f a l s i f y a p u b l i c r e c o r d ( s s . 8 3 9 . 1 3 , F . S . ) I c e r t i f y t h a t I h a v e e x a m i n e d t h i s r e p o r t a n d i t i s t r u e , c o r r e c t a n d c o m p l e t e J o h n M C a r r I c e r t i f y t h a t I h a v e e x a m i n e d t h i s r e p o r t a n d i t i s t r u e , c o r r e c t a n d c o m p l e t e T o n y O r t i z L J e l e c t i I n d i v i d u a o n e l e r ( o n l y i n f o r I T r e a s u r e r 1 D e p u t y T r e a s u r e r g X 1 c o m m o n . ) r �� 1 . X ; ��\ . C a n 1 t E ? . I C h a i r m a n m y f o r P C , P T Y & } { , e l e c t i o n e e r ' c o m m o n . o r g a n i z a t i o n ) X v ' S i g n a t u r e S i g n a t r e T h i s f o r m i s b a s e d o n D S - D E 1 2 ( R e v . 0 8 / 0 4 ) A d j u t a n t S o w a r e , I n c . . - C a m p a i g n T o o l B o x CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 12/27/2011 Segal, William I Develope r CHE DEL $ 200,00 60 12/27/2011 Segal, William 670 W. Fairbanks Ave Winter Park, FL 32789-0000 I Develope r CHE ADD $ 200.00 60 This farm is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 14 (Ray. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a Candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to .report on this form This form is based on DS -DE 14A (Rev. 0B/03) [Note about Committees has been removed.] Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 10/01/2011 - 12/31/2011 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial Institution Street Address & City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 94 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) (2) (4) Check X Antonio Ortiz OFFICE USE ONLY Name 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code Check box if address has changed appropriate box(es): Candidate (office sought): Commissioner District 2 (3) I.D. Number: 00000 Political Committee Check if PC has DISBANDED Committee of Continuous Existence Cover [X (5) REPORT IDENTIFIERS Period: From 01/01/2012 To 02/10/2012 Report Type: G1 Original Amendment 1 Special Election Report Independent Expenditure Report Cash Loans Total In -Kind (6) CONTRIBUTIONS THIS REPORT & Checks $2,660.00 Monetary Expenditures Transfers Account Total (7) EXPENDITURES THIS REPORT $13,619.77 / $0.00 to Office $0.00 /• Monetary $2,660.00 ' Monetary $13,619.77 $0.00 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date $43,664.45 (10) TOTAL Monetary Expenditures to Date $23,860.08 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct and complete John M Carr I certify true, that I have examined this report and it is correct and complete To v Ortiz Individual (only for Treasurer Deputy Treasurer electioneering XX commun.) X ......., a t Chairman (only for PC, P • electioneering commun. & ganization) Signature Signet re This form is base i-eo.,DSj E 12 (Rev. 08104) Adjutan are, Inc. Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 01/01/2012 - 02/10/2012 (2) I.D. Number 00000 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 01/05/2012 Payas, Payas & Payas, LLP 1018 E. Robinson St. Orlando, FL 32801-2024 B Law Firm CHE $ 500.00 1 01/11/2012 Christiansen, Patrick T. 500 Ivanhoe Plaza Orlando, FL 32804-0000 I Attorney CHE $ 200.00 2 01/17/2012 Cash America 1600 West 7th Street Fort Worth, TX 76102-0000 5 Financial Services CHE $ 500.00 3 01/17/2012 Saavedra, Lillian 1315 S. Orange Ave Orlando, FL 32806-0000 I Physician CHE $ 200.00 4 01/19/2012 Rural Metro Corp of Florida 4728 Old Winter Garden Rd Orlando, FL 32811-0000 B Ambulan ce Company CHE $ 400.00 5 01/19/2012 Cunningham Group, Inc. 10873 SW 59th Ct Miami, FL 33156-0000 B Consultin g CHE $ 250.00 6 01/19/2012 Thompson Wesley Wolfe LLC 1030 N Orange Ave Suite 220 Orlando, FL 32801-0000 B Consultin g CHE $ 200.00 7 01/30/2012 Amscot Corporation 600 N. Westshore Blvd Suite 1200 Tampa, FL 33609-0000 5 Financial Services CHE $ 250.00 8 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign Toolaox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 01/01/2012 - 02/10/2012 (2) I.D. Number 00000 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, Stale, zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 02/03/2012 Caddie, Robert 2143 Velvet Leaf Drive Ocoee, FL 34761-0000 I Engineer CHE $ 100.00 9 02/07/2012 Ramos, Mayra 11901 Cheltinham Dr Orlando, FL 32824-0000 I Consulta nt CHE $ 10.00 10 02/08/2012 Scanlon, Kathryn R. 102 Cove Colony Road Maitland, FL 32751-0000 I Administr ative Assistant CHE $ 50.00 11 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 01/01/2012 - 02/10/2012 (2) I.D. Number 00000 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 01/05/2012 In Touch Strategies, Inc. Consulting MON $ 2500.00 1716 Bobtail Drive Maitland, FL 32751-0000 1 01/10/2012 Cordero Studio Photo Section MON $ 100.00 440 Dean Creek Ln Orlando, FL 32825-0000 2 01/11/2012 Better Business Services Inc bookkeeping MON $ 250,00 1621 E Hillcrest Street Orlando, FL 32803-0000 3 01/19/2012 In Touch Strategies, Inc. Consulting MON $ 2500.00 1716 Bobtail Drive Maitland, FL 32751-0000 4 01/23/2012 Saavedra, Lillian Maxed Out Donations MON $ 200.00 1315 S. Orange Ave Limit Orlando, FL 32806-0000 5 01/23/2012 City of Orlando District 2 Qualification MON $ 1438.34 PO Box 4990 Orlando, FL 32802-0000 6 01/31/2012 Family Dollar Office Supplies MON $ 14.91 701 S Semoran Blvd Orlando, FL 32807-0000 7 01/31/2012 Best Buy Phone & Air Time MON $ 63.89 4601 East Colonial Drive Orlando, FL 32083-0000 8 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 01/01/2012 - 02/10/2012 (2) I.D. Number 00000 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 02/02/2012 Printmeisters of Orlando, Inc 10732 William Tell Dr Orlando, FL 32821-0000 Invitations MON $ 452.63 9 02/10/2012 In Touch Strategies, Inc. 1716 Bobtail Drive Maitland, FL 32751-0000 Consulting MON $ 4500.00 10 02/10/2012 InterMedia Solutions 471 Corniche Way #205 Lake Mary, FL 32746-0000 Set up fee for candidate MON $ 600.00 11 02/10/2012 In Touch Strategies, Inc. 1716 Bobtail Drive Maitland, FL 32751-0000 Consulting MON $ 1000.00 12 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 01/01/2012 - 02/10/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 14A (Rev. 08/03) (Note about Committees has been removed.) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 01/01/2012 - 02/10/2012 (2) I,D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial Institution Street Address 8 City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this forrr This form is based on DS -DE 94 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) Antonio Ortiz OFFICE USE ONLY Name (2) 1621 E Hillcrest St _ _ , t= w -_'n; '^ Address (number and street) Orlando, FL 32803 City, State, Zip Code Check box if address has changed (3) LD. Number 00000 (4) Check X appropriate box(es): Candidate (office sought): Commissioner District 2 Political Committee Li 1 Check if PC has DISBANDED Check if CCE has DISBANDED Check if no other electioneering communication reports will be filed (5) REPORT IDENTIFIERS Cover Period: From 02/11/2012 To 02/24/2012 Report Type: G2 X Original Amendment Special Election Report Independent Expenditure Report (6) CONTRIBUTIONS THIS REPORT Cash & Checks $2L600.00 (7) EXPENDITURES THIS REPORT Monetary Expenditures $200.00 Loans $0.00 Transfers to Office Account $0.00 Total Monetary $2,600.00 Total Monetary $200.00 In -Kind $0.00 (8) Other Distributions so.00 (9) TOTAL Monetary Contributions to Date $46,264.45 (10) TOTAL Monetary Expenditures to Date $24,060.08 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct and complete John M Carr I certify that I have examined this report and it is true, correct and complete To y Ortiz -- Individual (only for ] electioneering commun.) X X Treasurer Deputy Treasurer X X Can i . Chairman (only for PC, P & electioneering commun. o anization) Signature Signat e This form is based on DS -DE 12 (Rev. 08/04) Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 1 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & city, State, zip code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 02/13/2012 Amick Construction Co., Inc PO Box 568492 Orlando, FL 32856-8492 B Construct ion CHE $ 250.00 1 02/13/2012 Sea World Parks & Ent, Inc 9205 Southpark Center Loop Ste 400 Orlando, FL 32819-0000 B Theme Park & Entertain ment CHE $ 500.00 2 02/13/2012 Globe Executive Solutions, Inc. PO Box 194274 San Juan, PR 00919-4274 B Security CHE $ 500.00 3 02/14/2012 Nadal Arcelay, Rafael A. 403 Ave Munoz Rivera San Juan, PR 00918-0000 I Attorney CHE $ 500.00 4 02/15/2012 Mendez Gonzalez, Jose F. PO Box 21345 San Juan, PR 00928-1345 I University Presiden t CHE $ 500.00 5 02/16/2012 Alicea, Shaira L. Mansiones De Monte Casino 1 Buzon 355 Toa Alta, PR 00953-0000 I School Administr ator CHE $ 500.00 6 02/16/2012 Ortiz, Angel L. PO Box 191794 San Juan, PR 00919-0000 I Security MO $ 500.00 7 02/16/2012 Figueroa -Torres, Luis A. Urb. Cupey Gardens F-1 Calle 9 San Juan, PR 00926-7313 1 Interior Design CHE $ 500.00 8 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 2 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 02/17/2012 Catala, Franco I. 12 Calle Luhn Guaynabo, PR 00966-0000 I Attorney CHE $ 500.00 9 02/20/2012 Burgos, Luis A. PO Box 21345 San Juan, PR 00928-0000 I Professor CHE $ 500.00 10 02/21/2012 Dick Batchelor Management Group, Inc 201 S. Orange Ave. Suite 960 Orlando, FL 32801-0000 B Investor CHE $ 100.00 11 02/21/2012 MacDuffAmerica PO Box 2412 Daytona Beach, FL 32115-0000 B IJnderwrit er CHE $ 250.00 12 02/21/2012 Brown & Brown Insurance PO Box 2412 Daytona Beach, FL 32115-0000 B Insuranc e CHE $ 250.00 13 02/21/2012 Risk Management Associates, Inc PO Box 2416 Daytona Beach, FL 32115-0000 B Insuranc e CHE $ 250.00 14 02/21/2012 Rivera, Hector M. PO Box 9964 San Juan, PR 00908-0000 I Architect CHE $ 500.00 15 02/21/2012 Laureano-Martinez, Eduardo 61 Calle Sauco Toa Alta, PR 00953-0000 I Consultin g CHE $ 500.00 16 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 3 of 3 (5) Date (7) Full Name (Last, Suffix, First. Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 02/21/2012 Zayas-Seijo, Luis J. 831 Calle Vesta San Juan, PR 00923-0000 I University Vice - President CHE $ 500.00 17 02/21/2012 Perez-Caraballo, Jesus 1500 Ave Los Romeros Apt 1207 San Juan, PR 00926-7016 1 Consultin g CHE $ 500.00 18 02/23/2012 Gonzalez, Linda 3736 Brookmyra Drive Orlando, FL 32837-0000 1 NBA Executive CHE $ 100.00 19 02/23/2012 Martins, Alex 2703 Phillips Park Court Winter Park, FL 32789-0000 I NBA Executive CHE $ 500.00 20 02/23/2012 Fritz, James 630 Gatlin Ave Orlando, FL 32806-0000 1 NBA Executive CHE $ 100.00 21 02/23/2012 Lucas Boyce Holdings, Inc 4117 Fairview Vist Pt. Apt 304 Orlando, FL 32804-0000 B Investor CHE $ 300.00 22 This torn Is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign TodBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 02/13/2012 Better Business Services Inc 1621 E Hillcrest Street Orlando, FL 32803-0000 Bookkeeping MON $ 200.00 1 This fore.' is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign TodBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 14A (Rev. 08/03) [Note about Committees has been removed.] Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial Institution Street Address & City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (8) Sequence Number Nothing to report on this form This form is based on DS -DE 94 (Rev. 08/03) Adjutant Software, Inc. - Campaign To Box FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) (2) (4) Check X Antonio Ortiz OFFICE USE ONLY Name 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code Check box if address has changed appropriate box(es): Candidate (office sought): Commissioner District 2 (3) I.D. Number 00000 Political Committee Check if PC has DISBANDED Committee of Continuous Existence Party Executive Committee I Check if CCE has DISBANDED Electioneering Communication Check if no other electioneering communication reports will be filed Cover 1 (5) REPORT IDENTIFIERS Period: From 02/11/2012 To 02/24/2012 Report Type' G2 Original X Amendment f1 Special Election Report 1 Independent Expenditure Report Cash Loans Total In -Kind (6) CONTRIBUTIONS THIS REPORT & Checks $2,960,00 Monetary Expenditures Transfers Account Total (7) EXPENDITURES THIS REPORT $4,094.55 $0.00 to Office $0,00 Monetary $2,960.00 Monetary $4,094.55 $0.00 (8) Other Distributions $0,00 (9) TOTAL Monetary Contributions to Date $46,624.45 (10) TOTAL Monetary Expenditures to Date $27,954.63 (11) CERT FICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct and complete John M Carr I certify that I have examined this report and it is true, correct and complete Tony Ortiz r Individual (only for — Treasurer Deputy Treasurer J electioneering X commun.) X Can X X ' a Chairmen (only for PC, PTY eleclioneenng commun. organ ion) 4 Signature Signat re This form is based on DS -DE 12 (Rev. 08/04) - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 02/13/2012 Amick Construction Co., Inc PO Box 568492 Orlando, FL 32856-8492 B Construct ion CHE UPD $ 250.00 .1 02/13/2012 Sea World Parks & Ent, Inc 9205 Southpark Center Loop Ste 400 Orlando, FL 32819-0000 B Theme Park & Entertain ment CHE UPD $ 500.00 2 02/13/2012 Lucas Boyce Holdings, Inc 4117 Fairview Vist Pt. Apt 304 Orlando, FL 32804-0000 B Investor CHE UPD $ 300.00 3 02/17/2012 Ramos, Mayra 11901 Cheltinham Dr Orlando, FL 32824-0000 I Consulta nt CHE UPD $ 10.00 4 02/17/2012 Caddie, Robert 2143 Velvet Leaf Drive Ocoee, FL 34761-0000 1 Engineer CHE UPD $ 100.00 5 02/21/2012 MacDuff America PO Box 2412 Daytona Beach, FL 32115-0000 B Underwrit er CHE UPD $ 250.00 6 02/21/2012 Brown & Brown Insurance PO Box 2412 Daytona Beach, FL 32115-0000 B Insuranc e CHE UPD $ 250.00 7 02/21/2012 Risk Management Associates, Inc PO Box 2416 Daytona Beach, FL 32115-0000 B Insuranc e CHE UPD $ 250.00 8 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 02/21/2012 Brown & Brown Insurance PO Box 2412 Daytona Beach, FL 32115-0000 B Insuranc e CHE UPD $ 250.00 9 02/21/2012 Dick Batchelor Management Group, Inc 201 S. Orange Ave. Suite 960 Orlando, FL 32801-0000 B Investor CHE UPD $ 100.00 10 02/23/2012 Martins, Alex 2703 Phillips Park Court Winter Park, FL 32789-0000 1 NBA Executive CHE UPD $ 500.00 11 02/23/2012 Gonzalez, Linda 3736 Brookmyra Drive Orlando, FL 32837-0000 I NBA Executive CHE UPD $ 100.00 12 02/23/2012 Fritz, James 630 Gatlin Ave Orlando, FL 32806-0000 I NBA Executive CHE UPD $ 100.00 13 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Ina - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 02/13/2012 Better Business Services Inc 1621 E Hillcrest Street Orlando, FL 32803-0000 Bookkeeping MON UPD $ 200.00 1 02/14/2012 Printmeisters of Orlando, Inc. 10732 William Tell Drive Orlando, FL 32821-0000 Printing signs MON UPD $ 3088.50 2 02/14/2012 Studio Pacific, Inc. 5411 47th Avenue SW Seattle, WA 98136-0000 design MON UPD $ 300.00 3 02/15/2012 Paypal 2211 N 1st St San Jose, CA 95131-0000 service fee for Paypal payment MON UPD $ 5.50 4 02/17/2012 Paypal 2211 N 1st St San Jose, CA 95131-0000 fee for Paypal payment MON UPD $ 0.55 5 02/21/2012 In Touch Strategies, Inc. 1716 Bobtail Drive Maitland, FL 32751-0000 Consulting MON UPD $ 500.00 6 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 14A (Rev. 08/03) [Note about Committees has bean removed.] Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 02/11/2012 - 02/24/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial InstitutionAddress Street Address & City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 94 (Rev. 08103) Adjutant Software, Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF E,F,.CTI0,N$. s:. ,:; ;-r_,;, . CAMPAIGN TREASURER'S REPORT SU R �` ._n fli (1) (2) (4) Antonio Ortiz OFFICE USE ONLY -i. 2 A ' PH 2 Name 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code Check box if address has changed appropriate box(es): Candidate (office sought): Commissioner District 2 Check X (3) LD. Number 00000 Political Committee 7 Check if PC has DISBANDED Committee of Continuous Existence Party Executive Committee Check if CCE has DISBANDED Electioneering Communication Check if no other electioneering communication reports will be filed Cover X (5) REPORT IDENTIFIERS Period: From 02/25/2012 To 03/09/2012 Report Type- G Original Amendment Special Election Report Independent Expenditure Report Cash Loans Total In -Kind (6) CONTRIBUTIONS THIS REPORT & Checks $12,800.00 Monetary Expenditures Transfers Account Total (7) EXPENDITURES THIS REPORT $6,46L26 $0.00 to Office $0.00 Monetary $1/800.00 Monetary $6,461.26 $0.00 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date $59,4224.45 (10) TOTAL Monetary Expenditures to Date $34,415.89 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S,) I certify that I have examined this report and it is true, correct and complete John M Carr I certify that I have examined this report and it is true, correct and complete Tony Ortiz --- —"" X Individual (only for Treasurer Deputy Treasurer electi eerin X com n.) Cand' X X a r--- Chairman (only f c, PTY & electioneering com un. organizatbn) Signatu Sign re This form is based on DS -DE 12 (Rev. 08/04) Inc - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/25/2012 - 03/09/2012 (2) I.D. Number 00000 (4) Page 1 of 5 (5) Date (7) Full Name (Last, Suffix, First. Middle) Street Address & City, State, zp code Contributor Type (8) Occupation (9) Contribution Type (10) in -kind . Description (11) Amendment (12) Amount (8) Sequence Number 02/28/2012 Sharia, Alicia L. I School CHE $ 500.00 1 Buzon 355 Toa Atta, PR 00953-0000 Administr ator 1 02/28/2012 Globe Executive Solutions, Inc. B Security CHE $ 500.00 PO Box 194274 San Juan, PR 00919-4274 2 02/28/2012 Ortiz, Angel L. I Security CHE $ 500.00 PO Box 191794 San Juan, PR 00919-0000 3 02/28/2012 Rivera, Hector M. I Architect • CHE $ 500.00 PO Box 9964 San Juan, PR 00908-0000 4 02/28/2012 Mendez Gonzalez, Jose F. I University CHE $ 500.00 PO Box 21345 San Juan, PR 00928-1345 Presiden t 5 02/28/2012 Laureano-Martinez, Eduardo 61 Calle Sauco I Consultin g CHE $ 500.00 Toa Alta, PR 00953-0000 6 02/28/2012 Nadal Arcelay, Rafael A. I Attomey CHE $ 500.00 403 Ave Munoz Rivera San Juan, PR 00918-0000 7 02/28/2012 Burgos, Luis A. 1 Professor MO $ 500.00 PO Box 21345 San Juan, PR 00928-0000 8 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/25/2012 - 03/09/2012 (2) I.D. Number 00000 (4) Page 2 of 5 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (1 1) Amendment (12) Amount (6) Sequence Number 02/28/2012 Zayas-Seijo, Luis J. I University CHE $ 500.00 831 Calle Vesta Vice - San Juan, PR 00923-0000 President 9 02/28/2012 Catala, Franco I. I Attorney CHE $ 500.00 12 Calle Luhn Guaynabo, PR 00966-0000 10 02/28/2012 Perez-Caraballo, Jesus 1500 Ave Los Romeros Apt 1207 I Consultin g CHE $ 500.00 San Juan, PR 00926-7016 11 02/28/2012 Figueroa -Torres, Luis A. I Interior CHE $ 500.00 Urb. Cupey Gardens F-1 Calle 9 Design San Juan, PR 00926-7313 12 03/01/2012 Magic Kingdom, Inc B Theme CHE $ 500.00 1675 N Buena Vista Dr Park Orlando, FL 32830-0000 13 03/01/2012 Walt Disney Travel Company, Inc B Travel CHE $ 500.00 220 Celebration Place Suite 4000 Company Celbration, FL 34747-0000 14 - 03/01/2012 Mitzner, Ira 3120 Southwest Freeway, Ste 200 I Develope r CHE $ 500.00 Houston, TX 77098-0000 15 03/01/2012 Mitzner, David 3120 Southewest Freeway, Suite 200 I Develope r CHE $ 500.00 Houston, TX 77098-0000 16 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/25/2012 - 03/09/2012 (2) I.D. Number 00000 (4) Page 3 of 5 (5) Date (7) Full Name (Last, Suffix. First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (8) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/01/2012 Damiani, Luigi G. 3600 Lake Underhill Rd Orlando, FL 32803-0000 I Engineer CHE $ 200.00 17 03/01/2012 Fernandez, Jose B. 2683 Aloma Oaks Dr Oviedo, FL 32765-0000 I Economi c Develop ment Consult. CHE $ 200.00 18 03/01/2012 Richard Crotty Consulting Group, LLC P 0 Box 590072 Orlando, FL 32859-0000 B Consulta nt CHE $ 250.00 19 03/01/2012 Little, Joseph H. 5620 STAG THICKET LN Palm Harbor, FL 34685-0000 I Executive CHE $ 200.00 20 03/01/2012 Sullivan, Thomas 5520 Stag Thicket Ln Palm Harbor, FL 34685-0000 I Attorney CHE $ 50.00 21 03/01/2012 Kattelmann, James G. 3953 Wardell PL Orlandoo, FL 32814-0000 I Attorney CHE $ 150.00 22 03/01/2012 Brenner, Matthew G. 1330 Radclyffe Rd Orlando, FL 32804-0000 I Attomey CHE $ 50.00 23 03/01/2012 Furman, Rebecca 1355 Pelham Rd Winter Park, FL 32789-0000 I Attorney CHE $ 150.00 24 This Corm Is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/25/2012 - 03/09/2012 (2) I.D. Number 00000 (4) Page 4 of 5 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (1 h) Amendment (12) Amount (6) Sequence Number 03/01/2012 Ryan, Michael A. 139 W Fawsett Rd Winter Park, FL 32789-0000 1 Attorney CHE $ 200.00 25 03/01/2012 Fitzgerald, Miranda F. 9502 Sloane St Orlando, FL 32827-0000 I Attorney CHE $ 250.00 26 03/01/2012 Fildes, Richard J. 9602 Sloane ST Orlando, FL 32827-0000 I Attomey CHE $ 250.00 27 03/01/2012 Pope, Nicholas A. 2200 W Fawsett Rd Winter Park, FL 32789-0000 I Attomey CHE $ 250.00 28 03/01/2012 Mc Clelland, Herbert J. 10799 Harborside Dr Largo, FL 33773-0000 I Attomey CHE $ 100.00 29 03/02/2012 Omni Leasing of Central Florida, LTD P 0 Box 593108 Orlando, FL 32859-0000 B Leasing Company CHE $ 500.00 30 03/09/2012 Clear Channel Outdoor, Inc P O Box 659512 San Antonio, TX 78265-0000 B Marketing / Advertisi ng CHE $ 500.00 31 03/09/2012 Sun, Wenfang L. 5640 N Dean Rd Orlando, FL 32817-0000 I Executive CHE $ 500.00 32 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign TodBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 02/25/2012 - 03/09/2012 (2) I.D. Number 00000 (4) Page 5 of (5) Date (7) Full Name (Last. Suffix, First, Middle) Street Address a City, State, Zip code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (1.1) Amendment (12) Amount (6) Sequence Number 03/09/2012 Sun, D.O., Din -On 5640 N Dean Rd Orlando, FL 32817-0000 I Family Doctor CHE $ 500.00 33 03/09/2012 Seiu Florida State Council CCE 14645 NW 77th Avenue Suite 201 Miami Lakes„ FL 33014-0000 B Service Employe es CHE $ 500.00 34 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 02/25/2012 - 03/09/2012 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (Lest, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) . Amount (6) Sequence Number 02/28/2012 In Touch Strategies, Inc. Consulting MON $ 500.00 1716 Bobtail Drive Maitland, FL 32751-0000 1 03/01/2012 SunTrust bank fees MON $ 6.00 E Hillcrest St Orlando, FL 32803-0000 2 03/05/2012 Better Business Services Inc Accounting MON $ 200.00 1621 E Hillcrest Street Orlando, FL 32803-0000 3 03/08/2012 Ortiz, Tony repay loan MON $ 1000.00 Orlando, FL 32807-0000 4 03/09/2012 Royal Press print Signs MON $ 4255.26 973 W State Road 434 Longwood, FL 32750-0000 • 03/09/2012 Mitzner, David Duplicate payment MON $ 500.00 3120 Southewest Freeway, Suite 200 Houston, TX 77098-0000 6 This form Is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc, - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) (2) (4) Check X Antonio Ortiz OFFICE USE ONLY -w Name 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code Check box if address has changed appropriate box(es): Candidate (office sought): Commissioner District 2 (3) LD. Number: 00000 Political Committee Check if PC has DISBANDED Committee of Continuous Existence Party Executive Committee Check if CCE has DISBANDED Electioneering Communication ] Check if no other electioneering communication reports will be filed Cover X1 (5) REPORT IDENTIFIERS Period: From 03/10/2012 To 03/29/2012 Report Independent Type' G4 Original Amendment —! Special Election Report Expenditure Report Cash Loans Total In -Kind (6) CONTRIBUTIONS THIS REPORT & Checks $13,444.50 (7) EXPENDITURES Monetary Expenditures Transfers to Office Account Total Monetary THIS REPORT $29,819.28 $0.00 $0.00 Monetary $13,444.50 $29,819.28 $381.61 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date $72,868.95 (10) TOTAL Monetary Expenditures to Date $64,235.17 (11) CERTIFICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct and complete John M Carr I certify that I have examined this report and it is true, correct and complete Tony Ortiz — X Individual (only for Treasurer lDeputy Treasurer eledionaering }{ __ commun,) -I\J\ 1` Ca • }{ X , /r airman (only for PC, PTY 8 lactic aeering commun. organization) / ; Signatur Signature This form is based on DS -DE 12 (Rev. 08/04) Adjutant Software, Inc. - Cam CAMPAIGN TREASURER'S REPORT - ITEMIZED CON1RIBIJTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 1 of 8 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (8) Sequence Number 03/14/2012 LIN, MING SHENG 5104 W. COLONIAL DRIVE Orlando, FL 32808-0000 I CHEF CAS $ 50.00 1 03/14/2012 Wang, PING DI 5104 W. COLONIAL DRIVE Orlando, FL 32808-0000 I CONSTR UCTION CAS $ 50.00 2 03/14/2012 POON, NORMAN 1926 COMMON WAY RD. Orlando, FL 32814-0000 I RESTAU RANT OWNER CAS $ 50.00 3 03/14/2012 Zheng, Xiw He 5104 W. Colonial Drive Orlando, FL 32808-0000 I Chef CAS $ 50.00 4 03/14/2012 Universal City Travel Partners 1000 Universal Studios Plaza Orlando, FL 32819-0000 B Operator CHE $ 500.00 5 03/14/2012 Universal City Development Partners LTD. 1000 Universal Studios Plaza Orlando, FL 32819-0000 B Develope r CHE $ 500.00 6 03/14/2012 Florida Engeineering Group, Inc. 5127 South Orange Avenue, #200 Orlando, FL 32809-0000 B Engineer CHE $ 200.00 7 03/14/2012 Teco Energy Inc. 702 Franklin Street Tampa, FL 33602-0000 B Utilities Company CHE $ 500.00 8 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 2 of 8 (5) Date (7) Full Name (Lest, Suffix, First, Middle) Street Address & City, State, Zia Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/14/2012 Baggage Airline Guest Services 6751 Forum Dr., Suite 230 Orlando, FL 32821-0000 B Operator CHE $ 500.00 9 03/14/2012 Florida Chinese Business Association 13226 Meergate Circle Orlando, FL 32837-0000 B Civic Group CHE $ 200.00 10 03/14/2012 Chau, Agnes 716 E. Colonial Drive Orlando, FL 32803-0000 I Attorney CHE $ 250.00 11 03/14/2012 Evora, Orlando L. 1626 Spring Lake Drive Orlando, FL 32801-0000 I Attorney CHE $ 250.00 12 03/14/2012 Chapin, Linda W. 2022 Hoffner Ave. Orlando, FL 32809-0000 1 Retired CHE $ 100.00 13 03/14/2012 Goff, Jimmy 1538 Place Picardy Winter Park, FL 32789-0000 1 Engineer CHE $ 100.00 14 03/14/2012 Ho, Pauline 4525 Seafarer Way Orlando, FL 32817-0000 1 CPA CHE $ 50.00 15 03/14/2012 Sebaali, Sam Orlando, FL 32809-0000 1 Engineer CHE $ 150.00 16 This form is based on DS -DE 13 (Rev. 08103) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 3 of 8 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/14/2012 Gunter, Steve 2631 Rangley Ct. Orlando, FL 32835-0000 I Restaura nt Owner CHE $ 250.00 17 03/14/2012 Five Star Air Charter, LLC 480 S. Andrews Ave., Suite 103 Pompano Beach, FL 33069-0000 B Operator CHE $ 500.00 18 03/14/2012 Willard, James & Carol 228 West 7th Avenue Windermere, FL 34786-0000 I Attorney CHE $ 250.00 19 03/14/2012 Michael J Grindstaff Attorney At Law 300 S. Orange Ave., Suite 1000 Orlando, FL 32801-0000 B Attorney CHE $ 250.00 20 03/14/2012 Cruz, Ana L. 11248 Rouse Run Cir. Orlando, FL 32817-0000 I Executive Assistant CHE $ 50.00 21 03/14/2012 Zucker, Steven & Linda 1238 Scandia Terrace Oviedo, FL 32765-0000 1 Attorney CHE $ 100.00 22 03/15/2012 Cohen, Jules 1003 Lake Davis Orlando, FL 32806-0000 I Attorney CHE $ 25.00 23 03/15/2012 Pittenger, T. Todd 500 Florida Street Orlando, FL 32806-0000 I Attorney CHE $ 100.00 24 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 4 of 8 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/15/2012 Billingsley, III., William F. 3312 Renlee PL Orlando, FL 32803-0000 I Chief of Staff CHE $ 100.00 25 03/15/2012 Price, Scott M. 2618 Fawnlake Trail Orlando, FL 32828-0000 I Attorney CHE $ 50.00 26 03/15/2012 Whitlock, Gary A. 190 N Spring Trail Altamonte Springs, FL 32714-0000 I Attorney CHE $ 50.00 27 03/15/2012 Kefauver, Joseph L. 1622 Dormont Lane Orlando, FL 32804-0000 I Transport ation Policy Advisor CHE $ 50.00 28 03/15/2012 Brumback, Jr., Charles T. 1309 Country Lane Orlando, FL 32804-0000 I Attorney CHE $ 70.00 29 03/15/2012 Christiansen, Patrick T. 500 Ivanhoe Plaza Orlando, FL 32804-0000 I Attorney CHE $ 200.00 30 03/15/2012 McKinnon, Joel H. 701 Villa Bella Winter Park, FL 32789-0000 I Consulta nt CHE $ 250.00 31 03/21/2012 Hill, Lynn 5931 Navajo Way Orlando, FL 32807-0000 I Attorney MO $ 300.00 32 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 5 of 8 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/21/2012 Air Orlando Sales, Inc. PO Box 149225 Orlando, FL 32814-0000 B Retail CHE $ 50.00 33 03/21/2012 Forde, Michael 861 Garden Glen Loop Lake Mary, FL 32746-0000 1 CHE $ 25.00 34 03/21/2012 Miller, Katie S. 1351 American Elm Drive Altamonte Springs, FL 32714-0000 1 CHE $ 25.00 35 03/21/2012 Freeman, Charles Y. 202 Colony Springs Lane Maitland, FL 32751-0000 I Executive CHE $ 100.00 36 03/21/2012 Lucas Boyce Holdings, Inc 4117 Fairview Vist Pt. Apt 304 Orlando, FL 32804-0000 B Investor CHE $ 200.00 37 03/23/2012 Gianini, Elizabeth 150 E. Robinson Street Orlando, FL 32801-0000 1 Governm ental Affairs CHE $ 94.50 38 03/26/2012 Rolon, Orlando 2018 Westfall Drive Orlando, FL 32817-0000 I Consulta nt CHE $ 100.00 39 03/26/2012 Gilson's International Cuisine 5159 International Drive Orlando, FL 32819-0000 B Restaura nt CHE $ 300.00 40 This form is based on DS -DE 13 (Rev. 08103) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 6 of 8 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/26/2012 Moore Stephens Lovelace, P.A. 1201 South Orlando Ave. Winter Park, FL 32789-0000 6 Attorney CHE $ 250.00 41 03/26/2012 Perfumeland of Orlando 5161 International Drive Orlando, FL 32819-0000 B Retail CHE $ 500.00 42 03/26/2012 District 14 Committee for Economic Growth 3610 River Hall Drive Jacksonville, FL 32217-0000 B Civic Group CHE $ 50.00 43 03/26/2012 District 14 Government Relations Program 5385 Conroy Road Orlando, FL 32811-0000 B Civic Group CHE $ 50.00 44 03/26/2012 78 PAC 2153 W. Oak Ridge Road Orlando, FL 32809-0000 B Civic Group CHE $ 500.00 45 03/29/2012 Holland Builders, Inc. 4860 Northeast 12th Avenue Fort Lauderdale, FL 33334-0000 B Builders CHE $ 500.00 46 03/29/2012 Avcon, Inc. 5555 E. Michigan Street Orlando, FL 32822-0000 B Engineer s CHE $ 200.00 47 03/29/2012 Johnson Laux Construction 4502 35th Street, Suite 500 Orlando, FL 32811-0000 6 Construct ion CHE $ 250.00 48 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox " C A M P A I G N T R E A S U R E R ' S R E P O R T - I T E M I Z E D C O N T R I B U T I O N S ( 1 ) N a m e A n t o n i o O r t i z ( 3 ) C o v e r P e r i o d 0 3 / 1 0 / 2 0 1 2 - 0 3 / 2 9 / 2 0 1 2 ( 2 ) I . D . N u m b e r 0 0 0 0 0 ( 4 ) P a g e 7 o f 8 ( 5 ) D a t e ( 7 ) F u l l N a m e ( L a s t , S u f f i x , F i r s t , M i d d l e ) S t r e e t A d d r e s s & C i t y , S t a t e , Z i p C o d e C o n t r i b u t o r T y p e ( 8 ) O c c u p a t i o n ( 9 ) C o n t r i b u t i o n T y p e ( 1 0 ) I n - k i n d D e s c r i p t i o n ( 1 1 ) A m e n d m e n t ( 1 2 ) A m o u n t ( 6 ) S e q u e n c e N u m b e r 0 3 / 2 9 / 2 0 1 2 D o m i n g u e z , C a r m e n 1 0 8 0 K e y e s A v e n u e W i n t e r P a r k , F L 3 2 7 8 9 - 0 0 0 0 1 B u s i n e s s C o n s u l t a n t C H E $ 1 0 0 . 0 0 4 9 0 3 / 2 9 / 2 0 1 2 C r i s t o b a l C o n s t r u c t i o n G r o u p , L l c 1 5 2 4 A n n a C a t h e r i n e D r i v e O r l a n d o , F L 3 2 8 2 8 - 0 0 0 0 B C o n s t r u c t i o n C H E $ 2 5 . 0 0 5 0 0 3 / 2 9 / 2 0 1 2 H o l l a n d , G e r a l d 4 8 8 0 N e 1 2 t h A v e n u e O a k l a n d P a r k , F L 3 3 3 3 4 - 0 0 0 0 1 E x e c u t i v e C H E $ 5 0 0 . 0 0 5 1 0 3 / 2 9 / 2 0 1 2 J a d e P r o d u c t i o n G r o u p , I n c . 1 2 4 3 L a k e W i l l i s a r a C i r c l e O r l a n d o , F L 3 2 8 0 6 - 0 0 0 0 B E v e n t M a n a g e m e n t C H E $ 3 0 . 0 0 5 2 0 3 / 2 9 / 2 0 1 2 F l o r i d a R e a l t o r s P o l i t i c a l A c t i o n C o m m i t t e e 7 0 2 5 A u g u s t a N a t i o n a l D r i v e O r l a n d o , F L 3 2 8 2 2 - 0 0 0 0 B C i v i c G r o u p C H E $ 5 0 0 . 0 0 5 3 0 3 / 2 9 / 2 0 1 2 I n t e r n a t i o n a l B r o t h e r h o o d o f E l e c t o r a l W o r k e r s L U 8 2 0 V i r g i n i a D r i v e O r l a n d o , F L 3 2 8 0 3 - 0 0 0 0 B C i v i c G r o u p C H E $ 2 5 0 . 0 0 5 4 0 3 / 2 9 / 2 0 1 2 B o o t h , D e b r a 9 1 7 B l o o m i n g t o n C o u r t O c o e e , F L 3 4 7 6 1 - 0 0 0 0 1 P o l i t i c a l C o n s u l t a n t I N K R e f r e s h m e n t s / F u n d r a i s e $ 2 2 5 . 0 0 5 5 0 3 / 2 9 / 2 0 1 2 S e n t e r f i t t , A k e r m a n 4 2 0 S . O r a n g e A v e . O r l a n d o , F L 3 2 8 0 1 - 0 0 0 0 I A t t o r n e y I N K C a t e r i n g / F u n d r a i s e r $ 1 5 6 . 6 1 5 6 T h i s f o r m i s b a s e d o n D S - D E 1 3 ( R e v . 0 8 / 0 3 ) A d j u t a n t S o f t w a r e , I n c . - C a m p a i g n T o o l B o x CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 8 of 8 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/29/2012 Turnage, Robert 7 Trilby Branch Longwood, FL 32779-0000 I Banker CHE $ 250.00 57 03/29/2012 Central FL Hotel & Lodging Assoc. Inc 6675 Westwood Blvd Suite 210 Orlando, FL 32821-0000 B Civic Group CHE $ 500.00 58 03/29/2012 RPD Plaza Garage, LLC 1999 Avenue of The Stars # 1260 Los Angeles„ CA 90067-0000 B Parking Garage CHE $ 500.00 59 03/29/2012 RP Plaza Property LLC 1999 Avenue of The Stars # 1260 Los Angeles, CA 90067-0000 B Retail Manage ment Company CHE $ 500.00 60 03/29/2012 RP Altamonte II LLC 1999 Avenue of The Stars # 1260 Los Angeles, CA 90067-0000 B Property Manage ment Company CHE $ 500.00 61 03/29/2012 Long Beach Islandia, LLC 1999 Avenue of The Stars # 1260 Los Angeles„ CA 90067-0000 B Property Manage ment Company CHE $ 500.00 62 This form is based on DS -DE 13 (Rev. 06/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 1 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zp Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 03/15/2012 In Touch Strategies, Inc. Consulting MON $ 5050.00 1716 Bobtail Drive Maitland, FL 32751-0000 1 03/23/2012 Studio Pacific, Inc. Advertising MON $ 150.00 5411 47th Avenue SW Seattle, WA 98136-0000 2 03/23/2012 SunTrust Bank fees MON $ 5.50 E Hillcrest St Orlando, FL 32803-0000 3 03/27/2012 Action Mail Services Postage MON $ 1277.95 1904 Premier Row Orlando, FL 32809-0000 4 03/28/2012 Royal Press Advertising MON $ 1851.50 973 W State Road 434 Longwood, FL 32750-0000 5 03/28/2012 Action Mail Services Postage MON $ 1267.30 1904 Premier Row Orlando, FL 32809-0000 6 03/28/2012 Studio Pacific, Inc. Advertising MON $ 550.00 5411 47th Avenue SW Seattle, WA 98136-0000 7 03/28/2012 Studio Pacific, Inc. Advertising MON $ 500.00 5411 47th Avenue SW Seattle, WA 98136-0000 8 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign TodBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 2 of 3 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 03/28/2012 Studio Pacific, Inc. Advertising MON $ 125.00 5411 47th Avenue SW Seattle, WA 98136-0000 9 03/28/2012 Cordero Studio Advertising MON $ 200.00 440 Dean Creek Ln Orlando, FL 32825-0000 10 03/29/2012 Action Mail Services Postage MON $ 1299.84 1904 Premier Row Orlando, FL 32809-0000 11 03/29/2012 Studio Pacific, Inc. Advertising MON $ 450.00 5411 47th Avenue SW Seattle, WA 98136-0000 12 03/29/2012 Royal Press Advertising MON $ 634.05 973 W State Road 434 Longwood, FL 32750-0000 13 03/29/2012 Studio Pacific, Inc. Advertising MON $ 275.00 5411 47th Avenue SW Seattle, WA 98136-0000 14 03/29/2012 Printmeisters of Orlando, Inc Printing MON $ 2108.70 10732 William Tell Dr Orlando, FL 32821-0000 15 03/29/2012 Wonderstruk Media Web Developement MON $ 712.00 7186 Regina Way Orlando, FL 32819-0000 16 This torn is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox 3.33 CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 3 of 3 (5) Date _. (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 03/29/2012 Suntrust Merchant fees MON $ 13.75 Hillcrest Street Orlando, FL 32803-0000 17 03/29/2012 Winning Connections Campaign MON $ 7487.00 317 Pennsylvania Ave, SE Communication Washington, DC 20003-0000 18 03/29/2012 Winning Connections Campaign MON $ 4755.00 317 Pennsylvania Ave, SE Communications Washington, DC 20003-0000 19 03/29/2012 Better Business Services Inc Bookkeeping MON $ 600.00 1621 E Hillcrest Street Orlando, FL 32803-0000 20 03/29/2012 GODADDY.COM Website MON $ 13.01 14455 N Hayden Road Scottsdale, AZ 85260-0000 21 03/29/2012 Lowes Supplies for Billboards MON $ 493.68 3500 South Semoran Boulevard Orlando, FL 32822-0000 22 This Toren is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTAIBUtiON S (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix. First, Middle) Street Address 8 City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 14A (Rev. 08/03) [Note about Committees has been removed_] Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial Institution Street Address & City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 94 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) (2) (4) Check X __ Antonio Ortiz OFFICE USE ONLY Name 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code Check box if address has changed appropriate box(es): Candidate (office sought): Commissioner District 2 (3) LD. Number 00000 Political Committee Check if PC has DISBANDED Cover (5) REPORT IDENTIFIERS Period: From 03/10/2012 To 03/29/2012 Report Type: G4 Original X Amendment Special Election Report Independent Expenditure Report Cash Loans Total In -Kind (6) CONTRIBUTIONS THIS REPORT & Checks $13,450.00 Monetary Expenditures Transfers Account Total (7) EXPENDITURES THIS REPORT $29,819.28 $0.00 to Office $0.00 Monetary $13,450.00 Monetary $29,819.28 $381.61 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date $72,874.45 (10) TOTAL Monetary Expenditures to Date $64,235.17 (11) CERT FICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct and complete John M Carr I certify that I have examined th' rt and it is true, correct and complete To Ortiz Individual (only for 1 Treasurer Deputy Treasurer electioneer g }{ commun.) Can Chairman (onl for PC, PTY S ' electioneering mmun. organization) Signature Signatu This form is based on DS -DE 12 (Rev_ 08/04) Adjutant So are, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address 8 City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 03/21/2012 Hill, Lynn 5931 Navajo Way Orlando, FL 32807-0000 I Architect MO UPD $ 300.00 32 03/23/2012 Gianini, Elizabeth 150 E. Robinson Street Orlando, FL 32801-0000 I Governm ental Affairs CHE UPD $ 100.00 38 03/26/2012 Rolon, Giorgina 2018 Westfall Drive Orlando, FL 32817-0000 1 Consulta nt CHE LIPD $ 100.00 39 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 03/23/2012 Studio Pacific, Inc. 5411 47th Avenue SW Seattle, WA 98136-0000 Graphic Design MON UPD $ 150.00 2 03/28/2012 Royal Press 973 W State Road 434 Longwood, FL 32750-0000 Printing MON UPD $ 1851.50 5 03/28/2012 Studio Pacific, Inc. 5411 47th Avenue SW Seattle, WA 98136-0000 Graphic Design MON UPD $ 550.00 7 03/28/2012 Studio Pacific, Inc. 5411 47th Avenue SW Seattle, WA 98136-0000 Graphic Design MON UPD $ 500.00 8 03/28/2012 Studio Pacific, Inc. 5411 47th Avenue SW Seattle, WA 98136-0000 Graphic Design MON UPD $ 125.00 9 03/29/2012 Studio Pacific, Inc. 5411 47th Avenue SW Seattle, WA 98136-0000 Graphic Design MON UPD $ 450.00 12 03/29/2012 Royal Press 973 W State Road 434 Longwood, FL 32750-0000 Printing MON LIPD $ 634.05 13 03/29/2012 Studio Pacific, Inc. 5411 47th Avenue SW Seattle, WA 98136-0000 Graphic Design MON UPD $ 275.00 14 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc- - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 14A (Rev 08/03) [Note about Committees has been removed.] Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 03/10/2012 - 03/29/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial Institution Street Address & City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 94 (Rev. 08/03) Adjutant Software, Inc. - Campaign TeolBox Alternative Method Affidavit (Please Type) I certify that I intend to qualify by the alternative method as a candidate for the office of ;,57/Zi c 2 �`�` ' ;0A, (include district, circuit, group or seat numbers) as a: Partisan Candidate, Member of the Party j>zi No Party Affiliation Candidate (formerly independent) Nonpartisan Candidate (includes judicial offices) Under penalties of perjury, I declare that I have rea • e foregoing affidavit and that the facts stated in it e tru " 40,-.77z Print Name of Candidate J s' Residence Address (do not use post office box) ,(D.2 uRcl2) o ft, City ay Phone State ( ) Fax Number a O.3 Zip Code AFFIDAVIT OF FINANCIAL HARDSHIP £.4 _/ y, I, /4 lip ".// O 70A/7 U/LT/2, a candidate for the office of 0-e)."-4 "c ia,j d,V€4- Y.1T_ Z do hereby certify, pursuant to Section 99.093, Florida Statutes, that Y am unable to pay the 1% election assessment to qualify for nomination or election to public office because paying the assessment would be an undue burden on my personal financial resources or on the financial resources available to me. UNDER PENALTY OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THAT IT IS A TRUE AND CORRECT STATEMENT. Date AFFIDAVIT OF UNDUE BURDEN (Section 99.097(4), Florida Statutes) IMPORTANT: Paying signature gatherers will preclude or Invalidate the filing of an undue burden oath. Section 99.097(6), Florida Statutes, provides: (a) If any person is paid to solicit signatures on a petition, an undue burden oath may not subsequently be filed in lieu of paying the fee to have signatures verified for that petition. (b) If an undue burden oath has been filed and payment is subsequently made to any person to solicit signatures on a petition, the undue burden oath is no longer valid and a fee for all signatures previously submitted to the supervisor of elections and any submitted thereafter shall be paid by the candidate, person, or organization that submitted the undue burden oath. If contributions as defined in s. 106,011 are, received, any monetary contributions must first be used to reimburse the supervisor of elections for any signature verification fees that were not paid because of the filing of the undue burden oath. [Note: The second sentence in (b) applies only when payment is made to a signature gatherer after an undue burden oath had been filed.] ********************************* ****A** * ***** ** *****e******** I certify under oath that I intend to qualify as a candidate for the office of C; , Q/ c444j2 a eo^.t,*-( ; JJ)a.•srif-- L.�>s7. and that I am unable to pay the fee for verification of petition signatures for that office without imposing a • s due burden on my personal resources or on resources otherwis - availa le to me. State of Florida County of P/2 -14 -1‘)C -E-1: elephone Number Sworn to (or affirmed) and subscribed before me this / nt day of j'cU , , 20 I, by iU c e) " r-v/uV ' Personally Known: or Produced Identification: Type of Identification Produced: JLA 7(-67 Signature of No = ry - ublic -- Stet orida Print, Type or St- mp Commissioned Name of Notary Public 410"utt, DENISE HQLDRIDGE MY COMMISSION # DD947618 d EXPIRES: February 03, 2014 1404001 -Am PI. Notary D,.count Amos. Co. CANDIDATE OATH — NONPARTISAN OFFICE (Not for use by Judicial or School Board Candidates) c?"/ OATH OF CANDIDATE (Section 99.021, Florida Statutes) (PLEA E PRINT NAME 16 YOU WISH IT TO APPEAR ON THE BALLOT * - NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING am a candidate for th6 nonpartisan office of ;Iamaqu 4466 a.4404:443/4.0.4isto<, lsz 2. 1 ce► (district/) alified elector of /I County, Florida; (circuit 1) (group or seat 1) I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; I have qualified for no other public office In the state, the term of which office or any part thereof runs concurrent with the office I seek; and I have resin ed from any office from which I am required to resign pursuant to Section 99.012, Florida Statutes; and I will suppo the Constitution of the United States and the Constitution of the State of Flo 'd X 3-zfgx:. z— Number 04444 ap?/ ` . `l/ d/X44/bb 3"Zd c)3 Address City to ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card): * Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form): la net, Or feez. STATE OF FLORIDA COUNTY OF G1'GY C:re' Sworn to (or affirmed) and subscribed before me this ?)0 day of JiTIVL) 17 Personally Known: Produced Identification: or Type of Identification Produced: ✓�LL6C— Signature of Nota ublic Print, Type, or Stamp Commissioned Name of Notary Public , 20J 49°"'°x, DENISE HOLDRIDGE *MY COMMISSION # DD947618 d" EXPIRES: February 03, 2014 a 1-800 Ft. Notary t,i oaot Mom. Co. DS -DE 25 (Rev. 5111) Rule 1S-Z,OoO1, F.A.C. OF 2011 FORM 1 ACIAL Reese print or type your name, mailing address, agency name, and position below: FI N INTERESTSTEMENT 41 ; j f LAS ME -- FIRS)T NAME -- DLE NAME : /1- 7, 4ero�-i%) fie° � FOR OF' E2- USE ONLY: MAILING ADORES mil, c 0 ID Code CITY : ZIP : COUNTY ID No. NAME OF NCY : T% I �+ /t Dc) Conf. Code NWV OF OFFICE Qft POST�t/o�"'HELD OR SOUGHT :�) - VC aver?: P. Req. Code Z C.d LL T 004 deoli Q Z,W � to the e on the fines on this form. Attach additional sheets, if necessary. You are not Ii ta s CHECK OILY IF CANDIDATE OR L] NEW EMPLOYEE OR APPOINTEE **** BOTH PARTS OF THIS SECTION MUST BE COMPLETED **** DISCLOSURE PERIOD: THIS STATEMENT REFLECTS YOUR FINANCIAL INTERESTS FOR THE PRECEDING TAX YEAR, WHETHER BASED ON A CALENDAR YEAR OR ON A FISCAL YEAR. PLEASE STATE BELOW WHETHER THIS STATEMENT IS FOR THE PRECEDING TAX YEAR ENDING EITHER (must check one): Ild DECEMBER 31, 2011 ga ❑ SPECIFY TAX YEAR IF OTHER THAN THE CALENDAR YEAR: MANNER OF CALCULATING REPORTABLE INTERESTS: THE LEGISLATURE ALLOWS FILERS THE OPTION OF USING REPORTING THRESHOLDS THAT ARE ABSOLUTE DOLLAR VALUES, WHICH REQUIRES FEWER CALCULATIONS, OR USING COMPARATIVE THRESHOLDS, WHICH ARE USUALLY BASED ON PERCENTAGE VALUES (see instructions for further details). PLEASE STATE BELOW WHETHER THIS STATEMENT REFLECTS EITHER (must check one): ❑ COMPARATIVE (PERCENTAGE) THRESHOLDS DE ❑ DOLLAR VALUE THRESHOLDS PART A -- PRIMARY SOURCES OF INCOME (If you have nothing to report, you NAME OF SOURCE OFJjI COME [Major sources of income to the reporting person - See instructions must write "none" or "n/a") SOURCE'S ADDRESS p. 4] DESCRIPTION OF THE SOURCE'S PRINCIPAL BUSINESS ACTIVITY c2 . OA c41,QG19A0to _A 7:u IX CJA4i1(61.G' IdJ6) O' 44A444:14..1 5%0A/ PART B -- SECONDARY SOURCES [Major customers, clients, (If you have nothing to report NAME OF BUSINESS E/N�T�ITY OF INCOME and other sources of income to businesses , you must write "none" or "n/a") NAME OF MAJOR SOURCES OF BUSINESS' IN_COgME owned by the reporting person - See ADDRESS OF SOURCE instructions p. 4] PRINCIPAL BUSINESS ACTIVITY OF SOURCE(` jJ A /164$02%:% (%�• jir4/4/iCAT.); lioirC.• tbibe 01,41),--) gajef4,01^(400, irt., ....4tctC) PART C -• REAL PROPERTY [Land, buildings owned by the reporting person - See instructions p. 4] (If you have nothing to report, you must write "none or "n/a") FILING INSTRUCTIONS for when and where to file this form are located at the bottom of page 2. INSTRUCTIONS on who must file this form and how to fill it out begin on page 3. OTHER FORMS you may need to file are described on page 6. ®TTa ,{�y�'q,��y r�,/� ® •�/, II rwa33 " °� /� �� �i �'*/�jy� Cite 4 CE FORM 1 - Effective: January 1, 2012. Refer to Rule 34.8.202(1), F.A.C. (Continued on reverse side) PAGE 1 PART 0 — INTANGIBLE PERSONAL PROPERTY s, bonds, certificates of deposit, etc. - See instruction] (If you have nothing to report, you mu to "none" or "n/a") st/:0 E OF INTANGIBLE BUSINESS ENTITY TO WHICH THE PROPERTY RELATES PART E — LIABILITIES [Major debts - See instructions p. 5] (If you have nothing to report, you must write "none" or "n/a") N� ADDRESS OF CREDITOR PART F — INTERESTS IN SPECIFIED BUSINESSES [Ownership or positions in certain types of businesses - See instructions p. 5] (If you have nothing to report, you must write "none" or "n/a") S ENTITY # 1 BUSINESS ENTITY # 2 BUSIN BUSINESS ENTITY # 3 NAME OF BUSINESS ENTITY ADDRESS OF BUSINESS ENTITY PRINCIPAL BUSINESS ACTIVITY POSITION HELD WITH ENTITY I OWN MORE THAN A 5% INTEREST IN THE BUSINESS NATURE OF MY OWNERSHIP INTEREST IF ANY OF PARTS A THROUGH F ARE CONTINUED ON A SEPARATE SHEET, PLEASE CHECK HERE ❑ S WHA After completing all parts of this form, 'n •.. ;ianina and dating it, send back onl . - first sheet (pages 1 and 2) for filing. If you have nothing to report in a particular section, you must write "none or "n/a" in that section(s). NOTE: MULTIPLE FILING UNNECESSARY: Generally, a person who has filed Form 1 for a calendar or fiscal year is not required to file a second Form 1 for the same year- However, a candidate who previously filed Form 1 because of another public position must at least file a copy of his or her original Form 1 when qualifying - DATE S GNED reauired): �t3//z FILING INSTRUCTIONS: WHERE TO FILE: If you were mailed the form by the Commission on Ethics or a County Supervisor of Elections for your annual disclosure filing, return the form to that location. Local officers/employees file with the Supervisor of Elections of the county in which they permanently reside. (If you do not permanently reside in Florida, file with the Supervisor of the county where your agency has its headquarters.) State officers or specified state employees file with the Commission on Ethics, P.O. Drawer 15709, Tallahassee, FL 32317-5709: physical address: 3600 Maclay Boulevard, South, Suite 201, Tallahassee, FL 32312. Candidates file this form together with their qualifying papers. To determine what category your position falls under, see the "Who Must File" Instructions on page 3. Facsimiles will not be acceoted. WHEN TO FILE: Initially, each local officer/employee, state officer, and specified state employee must file within 30 days of the date of his or her appointment or of the beginning of employment. Appointees who must be confirmed by the Senate must file prior to confirmation, even if that is less than 30 days from the date of their appointment. Candidates for publicly -elected local office must file at the same time they file their qualifying papers. Thereafter, local officers/employees, state officers, and specified state employees are required to file by July 1st following each calendar year in which they hold their positions. Finally, at the end of office or employment, each local officer/employee, state officer, and specified state employee is required to file a final disclosure form (Form 1F) within 60 days of leaving office or employment. However, filing a CE Form 1F (Final Statement of Financial Interests) does not relieve the filer of filing a CE Form 1 if he or she was in their position on December 31, 2011. CE FORM 1 - Etfedive.- January 1, 2012. Refer to Rule 34-8202 (1), FA.C. PAGE 2 N N E OF CREDITOR FLORIDA DEPARTMENT OF STATE DIVISION OF ELECTIONS CAMPAIGN TREASURER'S REPORT SUMMARY (1) (2) (4) Check X _ I- L.__ Antonio Ortiz OFFICE USE ONLY Name 1621 E Hillcrest St Address (number and street) Orlando, FL 32803 City, State, Zip Code Check box if address has changed appropriate box(es): Candidate (office sought): Commissioner District 2 (3) ID. Number: 00000 Political Committee Check if PC has DISBANDED Party Executive Committee Committee of Continuous Existence L l l Check if GCE has DISBANDED Electioneering Communication L._. 1 Check if no other electioneering communication reports will be filed � Cover Xj (5) REPORT IDENTIFIERS Period: From_ 03/30/2012 To 05/03/2012 Report Type' TR 4 Original I Amendment Special Election Report Independent Expenditure Report Cash Loans Total In -Kind (6) CONTRIBUTIONS THIS REPORT & Checks -$110.00 Monetary Expenditures Transfers Account Total (7) EXPENDITURES THIS REPORT $8,529.28 $0.00 to Office $0.00 Monetary -$110.00 Monetary $8,529.28 $0.00 (8) Other Distributions $0.00 (9) TOTAL Monetary Contributions to Date $72,764.45 (10) TOTAL Monetary Expenditures to Date $72,764.43 (11) CERT FICATION It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.) I certify that I have examined this report and it is true, correct and complete John M Carr I certify true, that I have examined this report and it is correct and complete To v Ortiz X I Individual (only for Treasurer Deputy Treasurer f Ca i t 1 Chairman (only for PC, PTY �( electioneering commun, org ization) X Signatu Signature e This form is based on DS -DE 12 (Rev. 08!04) djutant Software, In Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED CONTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/30/2012 - 05/03/2012 (2) I.D. Number 00000 (4) Page 1 of 1 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code Contributor Type (8) Occupation (9) Contribution Type (10) In -kind Description (11) Amendment (12) Amount (6) Sequence Number 05/01/2012 Caddie, Robert 2143 Velvet Leaf Drive Ocoee, FL 34761-0000 I Engineer CHE $ -100.00 1 05/01/2012 Ramos, Mayra 11901 Cheltinham Dr Orlando, FL 32824-0000 I Consulta nt CHE $ -10.00 2 This form is based on DS -DE 13 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 03/30/2012 - 05/03/2012 (2) I.D. Number 00000 (4) Page 1 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 03/30/2012 SunTrust BANK FEE MON $ 35.00 E Hillcrest St Orlando, FL 32803-0000 1 04/03/2012 Racetrack fuel for vehicle MON $ 92.00 Orlando, FL 32803-0000 2 04/06/2012 In Touch Strategies, Inc. Consulting MON $ 500.00 1716 Bobtail Drive Maitland, FL 32751-0000 3 04/11/2012 In Touch Strategies, Inc. Refund REF $ -250.00 1716 Bobtail Drive Maitland, FL 32751-0000 4 04/13/2012 Royal Press Flyers MON $ 593.21 973 W State Road 434 Longwood, FL 32750-0000 5 04/13/2012 Royal Press Signs MON $ 1491.00 973 W State Road 434 Longwood, FL 32750-0000 6 04/16/2012 Winning Connections Refund REF $ -3564.83 317 Pennsylvania Ave, SE Washington, DC 20003-0000 7 04/16/2012 Owens, Robert Office Supplies RMB $ 83.83 8 This form is based on DS -DE 14 (Rev. Oft/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED EXPENDITURES (1) Name Antonio Ortiz (3) Cover Period 03/30/2012 - 05/03/2012 (2) I.D. Number 00000 (4) Page 2 of 2 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Expenditure Type (10) Amendment (11) Amount (6) Sequence Number 04/17/2012 Dix, David Printing MON $ 3500.00 317 Pennsylvania Ave. SE 2nd Floor Washington, DC 20003-0000 9 04/17/2012 Dix, David Printing MON $ 1985.00 317 Pennsylvania Ave. SE 2nd Floor Washington, DC 20003-0000 10 04/18/2012 Owens, Robert Event Expenses MON $ 499.00 11 04/19/2012 Action Mail Services Postage MON $ 1267.30 1904 Premier Row Orlando, FL 32809-0000 12 05/03/2012 ['SS wire transfer activity MON $ 200.00 8 N Central Avenue Idabel, OK 74745-0000 13 05/03/2012 Better Business Services Inc Accounting MON $ 2097.77 1621 E Hillcrest Street Orlando, FL 32803-0000 14 This form is based on DS -DE 14 (Rev. 08/03) Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - ITEMIZED DISTRIBUTIONS (1) Name Antonio Ortiz (3) Cover Period 03/30/2012 - 05/03/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Full Name (Last, Suffix, First, Middle) Street Address & City, State, Zip Code (8) Purpose (add office sought if contribution to a candidate) (9) Related Expenditures (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This tom, is based on DS -DE 14A (Rev. 08/03) [Note about Committees has been removed.] Adjutant Software, Inc. - Campaign ToolBox CAMPAIGN TREASURER'S REPORT - FUND TRANSFERS (1) Name Antonio Ortiz (3) Cover Period 03/30/2012 - 05/03/2012 (2) I.D. Number 00000 (4) Page 0 of 0 (5) Date (7) Name of Financial Institution Street Address & City, State, Zip Code (8) Transfer Type (9) Nature of Account (10) Amendment (11) Amount (6) Sequence Number Nothing to report on this form This form is based on DS -DE 94 (Rev, 08/03) Adjutant Software, Inc. - Campaign ToolBox