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Kenneth RukavinaCAL 1 700 200012001 FORm FAIR POLITICAL PRACTICES COMM. Please type or print in ink RECE Date Received STATEMENT OF ECONOMIC IQ%yZ@gAOSEMEAD of lint A Public Document MAR 21 2001 NAME (LAST) (FIRST) A KENNE' DAYTIME TELEPHONE NUMBER OPTIONAL: FAX I E-MAIL ADDRESS 13191 CROSSROADS PKWY N. #405 INDUSTRY CA 91746 krukavina @willdan.co COVER PAGE 1. Name of Office Sought or Held, Agency or 4. Schedule Summary Court (Provide precise name. Do not use acronyms.) - (Check applicable schedules 2 - No reportable interests.) CITY OF ROSEMEAD During the reporting period, did you have any reportable Division, Board, District, if applicable: interests to disclose on: Position: CONSULTANT -0 If Expanded Statement - List agency /position: (Attach a separate sheet it necessary Do not use acronyms. File . originally signed statement with each Kling official.) Agency: Position Title: 2. Office Jurisdiction (Check one) ❑ State Schedule A -1 ❑ Yes - schedule attached Investments (Leas man mx Ow.,ahip) Schedule A -2 ❑ Yes - schedule attached IOVestment5 (Grealarmen imb Ovmershlpl - Schedule B ❑ Yes - schedule attached Real Property Schedule C I� Yes - schedule attached Income 8- Business Positions (Income Other than Loans. Gilts, and naval) Schedule D ❑ Yes - schedule attached Income - Loans Schedule E ❑ Yes - schedule attached Income - Gifts ❑ County of Schedule F ' ❑ Yes - schedule attached M City of ROSEMEAD Income - Travel Payments ❑ Multi -County ❑ Other 3. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: _J __J— Annual (Check one) - (x The period covered is January 1, 2000, through December 31, 2000. O The period covered is through December 31, 2000. ❑ Leaving Office Date Left: ---J ---J— (Check one) O The period covered is January 1, 2000, through the date of leaving office. 0 The period covered is through the date of leaving office. a* ❑ No reportable interests on any schedule Total number of pages (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 under the laws of the State of California that the foregoing is true and correct. EXECUTED ON 3 '' • . 0 1 (month, day, year a SIGNATURE &i6 t (File the originally signed statement with your fikng official.) ❑ Candidate FPPC Form 700 (20002001) FPPC Toll -Free Helpline: 866/ASK -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 INDUSTRY CA 91746 BUSINESS. ACTIVITY. IF ANY, OF SOURCE YOUR BUSINESS POSITION - CONSULTANT GROSS INCOME RECEIVED ❑ $500 $1.000 [ 31,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ® Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale o! (Pmperry, car, bowl; etc.) ❑ Commission or ❑ Rental Income,, list each source of $10,000 or more ❑ Other (Dasrabe) > NAME OF SOURCE ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION - GROSS INCOME RECEIVED ❑ $500 - $t.000 ❑ $1,001 - $to,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income ❑ Loan repayment ❑ Sale of (Pmpedy, coq boat, etc.) ❑ Commission or ❑ Rental Income, list each spume of 510,000 or more ❑ Other ( Descibe) 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 - $10,00o ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's income - ❑ Loan repayment ❑ Sale of (Property car. boa(, etc.) ❑ Commission or []Rental Income, list each source of 510,000 ar more ❑ Other (Describe) > 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 (Properly, ceq boel, mJ ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Desmbe) FPPC Form 700 (2 0 0 012 0 01) Sch. C FPPC Toll -Free Helpllne: 8661ASK -FPPC