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Kenneth RukavinaCALIF ORNIA •- STATEMENT OF ECONOMIC INTERES ®( o I V o ived FAIR POLITICA� PRACTICES COMMISSION A Public Document MAR 1 3 2002 Please tune or mint in ink COVER PAGE -. 1. Full Name of Office Sought or Held, Agency or Court: CITY OF ROSEMEAD Division, Board, District, if applicable: Position: CONSULTANT m If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position Title: 2. Jurisdiction of Office (Check one box) ❑ State ❑ County of © City of ROSEMEAD ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: __J__J_ xl Annual: The period covered is January 1, 2001, through December 31, 2001. -or- 0 The period covered is _�� , through December 31. 2001. ❑ Leaving Office Date Left: (Check one) O The period covered is January 1, 2001, through the date of leaving office. -or- 0 The period covered is 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 [ - schedule attached Investments (Less than io% o..Np) Schedule A -2 ❑ Yes - schedule attached Investments (G.Isrlhan im O..shv) Schedule B ❑ Yes - schedule attached Real Property Schedule C © Yes - schedule attached Income & Business Positions (In.s Other Nan Loans, Gifts and T.M) Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached Income - Gifts Schedule F 0 Yes - schedule attached Income - Travel Payments -or- No reportable interests on any schedule Total number of pages completed including this cover page: 2 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 under the laws of the State of California that the foregoing is true and correct. Date Signed 03 -11 -02 � � t , (month, day, year) F Signature (Fite Ily signed statement with your filing oficial.) FPPC Form 700 (2001/2002) FPPC Toll -Free Helpline: 8661ASK -FPPC ('1=4 rI P: ' Pr": NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER RUKAVINA KENNETH 562 908 -6228 MAILING ADDRESS STREET CITY ZIP CODE OPTIONAL: FAX I E -MAIL ADDRESS (May be business address) 13191 CROSSROADS PKWY N. #405 INDUSTRY CA 91746 krukavina @willdan.com 1. Full Name of Office Sought or Held, Agency or Court: CITY OF ROSEMEAD Division, Board, District, if applicable: Position: CONSULTANT m If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position Title: 2. Jurisdiction of Office (Check one box) ❑ State ❑ County of © City of ROSEMEAD ❑ Multi- County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: __J__J_ xl Annual: The period covered is January 1, 2001, through December 31, 2001. -or- 0 The period covered is _�� , through December 31. 2001. ❑ Leaving Office Date Left: (Check one) O The period covered is January 1, 2001, through the date of leaving office. -or- 0 The period covered is 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 [ - schedule attached Investments (Less than io% o..Np) Schedule A -2 ❑ Yes - schedule attached Investments (G.Isrlhan im O..shv) Schedule B ❑ Yes - schedule attached Real Property Schedule C © Yes - schedule attached Income & Business Positions (In.s Other Nan Loans, Gifts and T.M) Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached Income - Gifts Schedule F 0 Yes - schedule attached Income - Travel Payments -or- No reportable interests on any schedule Total number of pages completed including this cover page: 2 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 under the laws of the State of California that the foregoing is true and correct. Date Signed 03 -11 -02 � � t , (month, day, year) F Signature (Fite Ily signed statement with your filing oficial.) FPPC Form 700 (2001/2002) FPPC Toll -Free Helpline: 8661ASK -FPPC SCHEDULE C Income & Business Positions (Income Other than Loans, Gifts, and Travel Payments) > NAME OF SOURCE KENNETH RUKAVINA- WILLDAN ADDRESS 13191 CROSSROADS PKWY N. #405 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION CONSULTANT GROSS INCOME RECEIVED ❑ $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 (P boat, etc.) ) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other ( Descnbe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $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 (prope rt Y. car, boat, etc.) ❑ Commission or ❑ Rental Income, list each soume of $10,000 or more ❑ Other (Describe) Comments: Name KENNETH RUKAVINA > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $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, eft.) ❑ Commission or ❑ Rental Income, list each spuroe or$10,000 ormore ❑ Other ( Descnbe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $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, ter, bowl, etc.) ❑ Commission or ❑ Rental Income, list each source or $10,000 Or more ❑ Other (Describe) FPPC Form 700 (200112002) S,_ FPPC Toll -Free Helpline: 8661A