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Jim GuerraSTATEMENT OF ECONOMIC COVER PAGE Please type or print in ink. NAME OF FILER �� 1. Office, Agency, or Court Agency Name CITY OF ROSEMEAD (LAST) Board, Department, District, if applicable (FIRST) Your Position JAMES CONSULTANT Date Received Iy ► If fling for multiple positions, list below or on an attachment. Agency: Position: 2. Jurisdiction of Office (check at least one box) ❑ State ❑ Multi- County ❑x City of ROSEMEAD ❑ Other 3. Type of Statement (check at least one box) 0 Annual: The period covered is January 1, 2011, through December 31, 2011. -or- The period covered is December 31. 2011. ❑ Assuming Office: Date assumed ❑ Candidate: Election Year O The period covered is the date of leaving office. Office sought, if different than Part 1: through 4. Schedule Summary Check applicable schedules or "None." ❑ Schedule A -1 - Investments - schedule attached ❑ Schedule A -2 - Investments - schedule attached ❑ Schedule B - Real Property - schedule attached ❑ Schedule C - Income, Loans, & Business Positions - schedule attached ❑ Schedule D - Income - Gifts - schedule attached ❑ Schedule E - Income - Gifts - Travel Payments - schedule attached .or- None - No reportable interests on any schedule 5. Verification MAILINGADDRESS STREET CITY STATE ZIP CODE (Business orAgency Address Recommended - Public Document) 13191 Crossroads Pkwy. North #405 Industry CA 91746 DAYTIME TELEPHONE NUMBER I E -MAIL ADDRESS (OPTIONAL) ( 562 ) 908 -6289 jguerra @willdan.com 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 acknowledge this is a public document. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed February 13, 2012 (month, day, year) ❑ Leaving Office: Date Left I (Check one) through O The period covered is January 1, 2011, through the date of leaving office. ► Total number of pages including this cover page: 2 Signature M ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of FPPC Form 700 (2011/2012) FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME JAMES M. GUERRA - WILLDAN ADDRESS (Business Address Acceptable) 13191 Crossroads Pky. N. #405 Industry, CA 91746 BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑X $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Partnership ❑ Sale of (Real property, car, boat, eta) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) (Real property, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source or $10,000 or more ❑ Other (Describe) LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING •• 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. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows. NAME OF LENDER` ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 INTEREST RATE TERM (MonthslYears) ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property Street address ❑ Guarantor ❑ Other Comments: NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) 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 or registered domestic partner's income ❑ Loan repayment ❑ Partnership ❑ Sale of City (Describe) FPPC Form 700 (2011/2012) Sch. C FPPC Toll -Free Helpline: 866 /275 -3772 w Jppc.ca.go f