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James Guerra
STATEMENT OF ECONOMIC Please type or print in ink COVER PAGE A Public Document R F_ Cm OntpWF=_(Q CITY OF ROSEMEAD -, L 2005 ntry INI EDrcle n�GICF. NAME (LAST) (FIRST) (MIDDLE) !' - - �ninvc ivu MBER GUERRA JAMES M ( 562 ) 908 -6200 MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS (May use business address) 13191 CROSSROADS PKWY N.#405 INDUSTRY CA 91746 jguerra @willdan.com 1 . Office, Agency, or Court Name of Of re, Agency, or Court: CITY OF ROSEME Division, Board, District, if applicable: Your Position: CONSULTING B O If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ County of ® City of ROSEMEAD ❑ Multi- County F nfhP, 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: __J __J ❑x Annual: The period covered is January 1, 2004, through December 31, 2004. .or- 0 The period covered is Jam through December 31, 2004. ❑ Leaving Office Date Left: ___J --- J (Check one) • The period covered is January 1, 2004, through the date of leaving office. -or- O The period covered is ___J ___J, through the date of leaving office. ❑ Candidate 4. Schedule Summary (Check applicable schedules or "No reportable interests.') +During the reporting period, did you have any reportable interests to disclose on: Schedule A -1 ❑ Yes - schedule attached Investments (Less than 10% Ownership) Schedule A -2 ❑ Yes - schedule attached Investments (10% or greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C ❑X Yes — schedule attached Income, Loans, & Business Positions (Income Other than Gifts and Travel Payments) Schedule D (Eliminated - report loans on Schedule C) Schedule E ❑ Yes - schedule attached Income - Gifts Schedule F ❑ Yes - schedule attached Income - Travel Payments -or- E] No reportable interests on any schedule Total number of pages completed including this cover page: ? 5. Verification I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I certify under penalty of perjury underthe laws of the State of California that the foregoing is true and correct. Date Signed MARCH 9. 2005 (month, day, year) Signature (File a originally signed statement with your filing official.) rPRC roan ruu tzuu4izuub) FPPC Toll -Free Helpline: 6661ASK -FPPC SCHEDULE C Income, Loans* & Business Positions Name (Other than Gifts and Travel Payments) JAMES M. GUERRA JAMES M. GUERRA - WILLDAN ADDRESS 13191 CROSSROADS PKWY N. #405 INDUSTRY BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION CONSULTING BUILDING OFFICIAL GROSS INCOME RECEIVEDIHIGHEST BALANCE DURING REPORTING PERIOD, IF LOAN ❑ $500 - $1,000 © $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑X Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Properly, car, boat, em) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) ❑ LOAN RECEIVED (complete box 2) 1. NAME OF SOURCE OF INCOME ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED /HIGHEST BALANCE DURING REPORTING PERIOD, IF LOAN ❑ $500 - $1,000 ❑ $1.001 - $10,00o ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Property, n,,, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) ❑ LOAN RECEIVED (complete box 2) ADDRESS BUSINESS ACTIVITY, IFANY, OF SOURCE _ -... YOUR BUSINESS POSITION GROSS INCOME RECEIVED /HIGHEST BALANCE DURING REPORTING PERIOD, IF LOAN ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Property, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) ❑ LOAN RECEIVED (complete box 2) INTEREST RATE TERM (Months/Years) ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property ❑ Guarantor ❑ Other (Describe) * You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Comments: FPPC Form 700 (200412005) Sch. C FPPC Toll -Free Helpline: 8661ASK -FPPC