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700 Pena 2016CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT Please type or print in ink. STATEMENT OF ECONOMIC INTERESTS COVER PAGE NAME OF FILER (LAST) Pena (FIRST) John Date Initial Filin Filed Date: 03/29/2017 12:12 PM SAN: FPPC (MIDDLE) 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of La Quinta Division, Board, Department, District, if applicable Your Position City Council Member N. If filing for multiple positions, list below or on an attachment. (Do not use acronyms) Agency: SEE ATTACHED LIST Position: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi -County ❑ County of ❑X City of La Quinta ❑ Other 3. Type of Statement (Check at least one box) • Annual: The period covered is January 1, 2016, through December 31, 2016. -or- The period covered is through December 31, 2016. ❑ Assuming Office: Date assumed _J1 ❑ Leaving Office: Date Left (Check one) p The period covered is January 1, 2016, through the date of leaving office. -or- O The period covered is / I , through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1 4. Schedule Summary (must complete) ► Total number of pages including this cover page: Schedules attached ❑ Schedule A-1 - Investments — schedule attached © Schedule A-2 - Investments — schedule attached ® Schedule B - Real Property — schedule attached -or- ▪ None - No reportable interests on any schedule ❑X Schedule C - Income, Loans, & Business Positions — schedule attached ❑ Schedule D - Income — Gifts — schedule attached ❑ Schedule E - Income — Gifts — Travel Payments — schedule attached 5. Verification MAILING ADDRESS STREET (Business or Agency Address Recommended - Public Document) 78495 Calle Tampico La Quinta STATE ZIP CODE CA 92253-2839 DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS ( 760 ) 777-7030 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 Date Signed 03/29/2017 12:12 PM Signature (month, day, year) (File the originally signed statement your filing official.) FPPC Form 700 (2016/2017) FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov STATEMENT OF ECONOMIC INTERESTS COVER PAGE ATTACHMENT EXPANDED STATEMENT LIST Agency Name Division, Board, Department, District Coachella Valley Mountains Conservancy Position or Titk Alternate Board Member CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name John Pena Jurisdiction State California Type of Period Covered Statement Annual 01101'16- 12/31/16 SunLine Transit Agency Alternate Board Riverside Annual 01/01/16 — 12/31/16 Member County Coachella Valley Riverside Annual 01/01/16 — 12/31/16 Association of Member County Governments SCHEDULE A-2 Investments, Income, and Assets of Business Entities/Trusts (Ownership Interest is 10% or Greater) 10, 1. BUSINESS ENTITY OR TRUST EMERALD PRESIDIO, INC. Name PO BOX 671, LA QUINTA, CA 92247 Address (Business Address Acceptable) Check one ❑ Trust, go to 2 l❑ Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS FOOD SERVICE FAIR MARKET VALUE IF APPLICABLE, LIST DATE: FT $0 - $1,999 Iv] 52,00o - 510,000 / / 16 / / 16 El $10,001 - sioo,000 ACQUIRED DISPOSED Q $100,001 - $1,000,000 U Over $1,000,000 NATURE OF INVESTMENT S CORP • Partnership • Sole Proprietorship 0 Other YOUR BUSINESS POSITION OFFICER ► 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) 50 - $499 • 510,001 - $100,000 $500 - $1,000 © OVER $100,000 ❑ 51,001 - $10,000 P. 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10.000 OR MORE ,Au.,, I, ., .ena,<e.. a,�„, .1 ,,,,,, ,„y • None or © Names listed below THE PALMS GOLF CLUB ► 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST Check one box: • INVESTMENT [/ REAL PROPERTY DESERT CITIES CATERING Name of Business Entity, if Investment, gr Assessor's Parcel Number or Street Address of Real Property 57000 PALMS DRIVE, LA QUINTA, CA Description of Business Activity or City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: ❑ $2,000 - $10,000 $10,001 - $100,000 / / 16 / / 16 0 5100,001 -51,0a,000 ACQUIRED DISPOSED ❑ Over 51,000,000 NATURE OF INTEREST • Property Ownership/Deed of Trust II Stock I♦ Partnership © Leasehold 1 • Other Yrs. remaining • Check box if additional schedules reporting investments or real property are attached CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION I. 1. BUSINESS ENTITY OR TRUST JOHN PENA & ASSOCIATES Name 51405 CALLE HUENEME, LA QUINTA, CA 92253 Address (Business Address Acceptable) Check one D Trust, go to 2 ❑Y Business Entity, complete the box, then go to 2 GENERAL DESCRIPTION OF THIS BUSINESS CONSULTING FAIR MARKET VALUE IF APPLICABLE, LIST DATE: n $0 - $1,999 ❑ 52,000 - $10,000 / , 16 / / 16 0 $1o,00i - $1oo 000 ACQUIRED DISPOSED D $100,001 - 51,000,000 D Over $1,000,000 NATURE OF INVESTMENT • Partnership © Sole Proprietorship • On.. YOUR BUSINESS POSITION PRINCIPAL I. 2, IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) $0 - $499 © 510,001 - $100,000 • $500 - $1,000 • OVER $100,000 0 51,001 - $10,000 ► 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF INCOME OF $10.000 OR MORE lAaa,11 , Srr.i,A11 anePl 11 .ece,,ry.; ❑ None or IX, Names listed below SEE ATTACHED ► 4 INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST Chick one box: • INVESTMENT rj REAL PROPERTY EMERALD PRESIDIO, INC Name of Business Entity, if Investment. 9! Assessor's Parcel Number or Street Address of Real Property 74710 HWY. 111, PALM DESERT, CA Description of Business Activity or City or Other Precise Location of Real Property FAIR MARKET VALUE IF APPLICABLE, LIST DATE: F3 $2,000 - $10,000 • $10,001 - $100,000 01 t 16 / / 16 -09] ❑ 5100,001 - $1,000,000 ACQUIRED DISPOSED • Over 51,000,000 NATURE OF INTEREST • Property Ownership/Deed of Trust El Stock In Partnership © Leasehold 1 • Other Yrs. remaining • Check box if additional schedules reporting investments or real property are attached Comments: FPPC Form 700 (2016/2017) Sch. A-2 FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE A-2 Attachment BUSINESS ENTITY OR TRUST : JOHN PENA & ASSOCIATES CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION LIST OF REPORTABLE SINGLE SOURCES OF INCOME OF $10,000 OR MORE SELAN LAW FIRM ENGLANDER KNABE ALLEN & ASSOCIATES TERRY ROSS ENTERPRISES MSM ASSOCIATES SCHEDULE B Interests in Real Property (Including Rental Income) ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS 51910 AVENIDA NAVARRO CITY LA QUINTA, CA FAIR MARKET VALUE IF APPLICABLE, LIST DATE: • $2,000 - $10,000 ■ $10,001 - $100,000 / / 16 / / 16 n $100,001 - $1,000,000 ACQUIRED DISPOSED • Over $1,000,000 NATURE OF INTEREST n Ownership/Deed of Trust • Easement ❑ Leasehold • Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED • $0 - $499 • $500 - $1,000 • 51,001 - $10,000 n $10,001 - $100,000 • OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% or greater interest, list the name of each tenant that is a single source of income of $10,000 or more. • None MARK S. MORAN CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name John Pena ► ASSESSOR'S PARCEL NUMBER OR STREET ADDRESS CITY FAIR MARKET VALUE ❑ $2,000 - $10,000 ❑ $10,001 - $100,000 ❑ 5100,001 - 51,000,000 ❑ Over $1,000,000 IF APPLICABLE, LIST DATE: 16 / /16 ACQUIRED DISPOSED NATURE OF INTEREST ❑ Ownership/Deed of Trust ❑ Easement ❑ Leasehold Yrs. remaining Other IF RENTAL PROPERTY, GROSS INCOME RECEIVED ❑ $0 - $499 ❑ $500 - $1,000 ❑ $1,001 - 510,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 SOURCES OF RENTAL INCOME: If you own a 10% Or greater interest, list the name of each tenant that is a single source of income of 510,000 or more. ❑ None * You are not required to report loans from commercial lending institutions 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) NAME OF LENDER' ADDRESS (Business Address Acceptable) BUSINESS ACTIVITY, IF ANY, OF LENDER 1 1 BUSINESS ACTIVITY, IF ANY, OF LENDER INTEREST RATE TERM (Months/Years) INTEREST RATE TERM (Months/Years) ❑ None % ❑ None HIGHEST BALANCE DURING REPORTING PERIOD HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ 510,001 - 5100,000 ❑ 51,001 - 510,000 ❑ OVER $100,000 ❑ $500 - 51,000 ❑ $10,001 - 5100,000 ❑ Guarantor, if applicable 1 1 ❑ Guarantor, if applicable Comments: ❑ $1,00i - 510,000 ❑ OVER $100,000 FPPC Form 700 (2016/2017) Sch. B FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) ► 1, INCOME RECEIVED NAME OF SOURCE OF INCOME MARKETSTAR CORP I. 1. INCOME RECEIVED CALIFORNIA FORM 700 FAIR POLITICAL PRAC1 ICES COMMISSION Name John Pena NAME OF SOURCE OF INCOME GROUND BREAKING COMMUNICATIONS ADDRESS (Business Address Acceptable) ADDRESS (Business Address Acceptable) 2475 WASHINGTON BLVD., OGDEN, UT BUSINESS ACTIVITY, IF ANY, OF SOURCE COMMUNICATIONS YOUR BUSINESS POSITION TERRITORY MANAGER GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑X $10,001 - $100,000 ❑ No Income - Business Position Only ❑ $1,001 - 810,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑X Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of (Real property, car, boat, etc) ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of $10,000 or more (Describe) ❑ Other (Describe) 21500 NORDHOFF ST., CHATSWORTH, CA BUSINESS ACTIVITY, IF ANY, OF SOURCE COMMUNICATIONS YOUR BUSINESS POSITION AREA MANAGER GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑X $10,001 - $100,000 ❑ No Income - Business Position Only ❑ $1,001 - $10,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑X Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of (Real property, car, boat, etc) ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) (Describe) 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * 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 Comments: INTEREST RATE TERM (Months/Years) ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property ❑ Guarantor Street address City ❑ Other (Describe) FPPC Form 700 (2016/2017) Sch. C FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name John Pena ► 1, INCOME RECEIVED ► 1. INCOME RECEIVED NAME OF SOURCE OF INCOME DESERT CITIES CATERING NAME OF SOURCE OF INCOME ADDRESS (Business Address Acceptable) ADDRESS (Business Address Acceptable) PO BOX 671 LA QUINTA, CA BUSINESS ACTIVITY, IF ANY, OF SOURCE BUSINESS ACTIVITY, IF ANY, OF SOURCE CATERING/FOOD SERVICE YOUR BUSINESS POSITION OWNER GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑X $10,001 - $100,000 ❑ No Income - Business Position Only ❑ $1,001 - $10,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑X Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of (Real property, car, boat, etc) ❑ Loan repayment ▪ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) (Describe) YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $10,001 - $100,000 ❑ No Income - Business Position Only ❑ $1,001 - $10,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income (For self-employed use Schedule A-2.) ❑ Partnership (Less than 10% ownership. For 10% or greater use Schedule A-2.) ❑ Sale of (Real property, car, boat, etc) ❑ Loan repayment ❑ Commission or ❑ Rental Income, list each source of $10,000 or more (Describe) ❑ Other (Describe) ► 2. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD w 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 Comments: INTEREST RATE TERM (Months/Years) ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property Street address ❑ Guarantor City ❑ Other (Describe) FPPC Form 700 (2016/2017) Sch. C FPPC Advice Email: advice@fppc.ca.gov FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov