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CALIFORNIA FORM 700 STATEMENT OF ECONOMIC INTERESTS
FAIR POUT/GAL PRACTJCES COMMISSION CITY CLERK'S OFFICE
A PUBLIC DOCUMENT COVER PAGE BY:
Please type or print in ink
NAME OF FILER (LAST( (FIRST) (MIDDLE_)
Armenia Sandra L
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Rosemead
Division, Board, Department, District, if applicable Your Position
City Council Council Member
• It filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency. Position
2. Jurisdiction of Office (Check at least one box)
▪State ❑Judge or Cowl Commissioner(Statewide Jurisdiction)
❑Multi-County ❑County of
0 City of Rosemead
❑Other
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1,2015,through ❑ Leaving Office: Date Left I J
December 31,2015. (Check one)
or-
The period covered is_/_/ , through O The period covered is January 1, 2015, through the date of
December 31.2015. leaving office.
-or-
❑ Assuming Office: Date assumed_lam 0 The period covered is J I ,through
the date of leaving office.
❑ Candidate: Election year and office sought,if diHerent than Pad 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page: 3
Schedules attached
❑ Schedule A-1 •Investments-schedule attached ❑Schedule C-Income,Loans, &Business Positions-schedule attached
❑ Schedule A-2•Investments-schedule attached Schedule 0•Income-Gifts-schedule attached
❑ Schedule B-Reel Property-schedule attached ❑Schedule E•Income-Gifts-Travel Payments-schedule attached
-or-
_ 0 None-No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE 2P CODE
(Bushes or Agemy Adoress RecomrreMW-Public Document)
8838 E.Valley Blvd. Rosemead CA 91770
DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS
( 626 ) 569-2100 sarmenta @cityofrosemead.org
I have used all reasonable diligence in preparing the 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 03/31/2016 Signature * ! ' •®
(ronth tin yea) peek &nallyslped styemeed SYM1 youraany otriSI.)
FPPC Form 700(2015/2016)
FPPC Advice Email:advice @fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
CALIFORNIA FORM 700
SCHEDULE D FAIR POLITICAL PRACTICES COMMISSION
Name
Income — Gifts
Sandra Armenta
• NAME OF SOURCE(Not an Acronym) NAME OF SOURCE(Not an Acronym)
League of California Cities Latino Caucus League of California Cities Latino Caucus
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
770 L. Street, Suite 1030 Sacramento, CA 95814 770 L.Street, Suite 1030 Sacramento,CA 95814
BUSINESS ACTIVITY.IF ANY OF SOURCE BUSINESS ACTIVITY,IF ANY.OF SOURCE
Annual Board Retreat Annual Board Retreat
DATE(mMddiyy) VALUE DESCRIPTION OF GIFT(S) DATE(mmlddlyy) VALUE DESCRIPTION OF GIFT(S)
Ot /23 115 $ 118.00 Dinner 01 / 24 / 15 $ 127.00 Dinner
01 124 115 s 38.00 Breakfast 01 /251 15 $ 37.00 Breakfast
01 1 24 / $15 69.00 Lunch _J_)_ $
• NAME OF SOURCE(Not an Acronym) t NAME OF SOURCE(Not an Acronym)
League of California Cities Latino Caucus League of California Cities Latino Caucus
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
770 L. Street, Suite 1030 Sacramento, CA 95814 770 L. Street, Suite 1030 Sacramento, CA 95814
BUSINESS ACTIVITY, IF ANY OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE
Mid-Year Board Retreat League of California Cities Annual Conference
DATE(mmldd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mMtldfyy) VALUE DESCRIPTION OF GIFT(S)
07 / 10 1 15 $ 70.88 Dinner 101 01 r 15 $ 18.33 Reception
07 / 11 / $15 26.00 Breakfast —1_1 $
07 / 11 1 $15 38.00 Lunch _/_/ $
PI. NAME OF SOURCE(Not an Acronym) • NAME OF SOURCE(Not an Acronym)
California Contract Cities Association California Contract Cities Association
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
11027 Downey Ave. Downey, CA 90241 11027 Downey Ave. Downey, CA 90241
BUSINESS ACTIVITY,IF ANY,OF SOURCE BUSINESS ACTIVITY,IF ANY,OF SOURCE
Executive Board Meetings Executive Board Meetings
DATE(mnvddlyy) VALUE DESCRIPTION OF GIFT(5) DATE(mm/ddlyy) VALUE DESCRIPTION OF GIFT(S)
07/24 1 15 $ 57.57 Dinner 11 1 04 1 15 $ 42.48 Dinner
09 /02115 $ 52.26 Dinner 12102115 $ 60.63 Dinner
10 /07 / $15 49.14 Dinner _/_/ $
Comments:
FPPC Form 700(2015/2016)5ch.0
FPPC Advice Email:advice @fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov
CALIFORNIA FORM 700
SCHEDULE D FAIR POLITICAL PRACTICES coumisPos
Income — Gifts Name
Sandra Armenta
1. NAME OF SOURCE(Not an Acronym) ■ NAME OF SOURCE(Not an Acronym)
Republic Services Republic Services
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
2531 East 67th Street Long Beach, CA 90805 2531 East 67th Street Long Beach, CA 90805
BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY OF SOURCE
California Contract Cities Annual Municipal Seminar Los Angeles Dodger Tickets
DATE(mmldwyy) VALUE DESCRIPTION OF GIFT(S) DATE(mMtltllyy) VALUE DESCRIPTION OF GIFT(S)
05 15 15 $ 100.00 Dinner for 2 08 10 15 $ 300.00 4 Dodger Tickets
JJ— $
PA NAME OF SOURCE(Not an Acronym) • NAME OF SOURCE(Not an Acronym)
Advance America Advance America
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
135 N. Church St.Spartanburg, SC 29306 135 N.Church St. Spartanburg, SC 29306
BUSINESS ACTIVITY, IF ANY,OF SOURCE BUSINESS ACTIVITY,IF ANY.OF SOURCE
VICA State Officeholders Dinner VICA Local Officeholders Luncheon
DATE(mMdd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mMddiyy) VALUE DESCRIPTION OF GIFT(S)
02 /20 / 15 $ 250.00 Dinner 08 r 13/ 15 $ 200.00 Luncheon
JJ_ $ JJ— $
JJ— $ _/J $
PA NAME OF SOURCE(Not an Acronym) IA NAME OF SOURCE(Not an Acronym)
ADDRESS(Business Address Acceptable) ADDRESS(Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY.OF SOURCE BUSINESS ACTIVITY,IF AN OF SOURCE
DATE(mMdd/yy) VALUE DESCRIPTION OF GIFT(S) DATE(mm/ddryy) VALUE DESCRIPTION OF GIFT(S)
J J— $ JJ— $
JJ— $ JJ— $
J J— $ JJ— $
Comments:
FPPC Form 700(2015/2016)Sch.D
FPPC Advice Email:advice@fppc.ca.gov
FPPC Toll-Free Helpline:866/275-3772 www.fppc.ca.gov