700 HR Green Pacific (Wentz) 2021STATEMENT OF ECONOMIC INTERESTS DaRInitialEFilingD tRec
COVER PAGE Filing Official Use Only
MAR 312022
A PUBLIC DOCUMENT
Please type or print in ink. CITY OF LA QUINTA
CITY CLFRK f7FPARTMEP
NAME OF FILER (LAST) (FIRST) (MIDDLE)—
WENTZ GEORGE ANDREW
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CITY OF LA QUINTA, CALIFORNIA
Division, Board, Department, District, if applicable
PUBLIC WORKS
Your Position
PRINCIPAL IN CHARGE CONSULTING
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction of Office (Check at least one box)
L— State
F_ Multi -County
M City of LA QUINTA
3. Type of Statement (check at least one box)
® Annual: The period covered is January 1, 2021, through
December 31, 2021.
-or-
The period covered is
December 31, 2021.
H Assuming Office: Date assumed !�
U Candidate: Date of Election
Position:
n Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
n County of
❑ Other
LI Leaving Office: Date Left J .
(Check one circle.)
through L-1 The period covered is January 1, 2021, through the date of
-or-
leaving office.
_ U The period covered is I I through
the date of leaving office.
and office sought, if different than Part 1:
Schedule Summary (must complete) ► Total number of pages including this cover page: 3
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
i Schedule C - Income, Loans, & Business Positions — schedule attached
L Schedule D - Income — Gifts — schedule attached
L— Schedule E - Income — Gifts — Travel Payments — schedule attached
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
1260 CORONA POINTE COURT, SUITE 305 RIVERSIDE CA 92879
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 949 ) 939-5243 GWENTZ@HRGREEN.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 foregoingJs true and carrpct.,
Date Signed 3/31 /2022 Signature Z
Form 700 - Cover Page (2021/2022)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 5
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests plame
(Ownership Interest is Less Than 10%)
Investments must be itemized. GEORGE ANDREW WENTZ
Do not attach brokerage or financial statements.
► NAME OF BUSINESS ENTITY ► NAME OF BUSINESS ENTITY
HR GREEN INC.
GENERAL DESCRIPTION OF THIS BUSINESS
ENGINEERING & MANAGEMENT CONSULTING
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
■ $100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT NATURE OF INVESTMENT
■ Stock Other Stock Other
(Describe) (Describe)
Partnership Income Received of $0 - S499 Partnership Income Received of $0 - $499
Income Received of $500 or More (Report on schedule C) Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE: IF APPLICABLE, LIST DATE:
---I-12_ -j-12L
ACQUIRED DISPOSED ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 �. Over $1,000,000
NATURE OF INVESTMENT
Stock Other
(Dascriba)
Partnership Income Received of $0 - $499
I Income Received of $500 or More (Repon on schedule c)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
$2.000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 Over S1,000,000
NATURE OF INVESTMENT
Stock Other
tuescrioaj
Partnership 1 Income Received of $0 - $499
Income Racelved of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
Comments:
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
$2,000 - $10,000 $10,001 - $100,000
$100,001 - $1,000,000 over $1,000,000
► NAME OF BUSINESS ENTITY
GffN`EffA—LTr§Cr17f1-0R OF THIS BUSINESS
FAIR MARKET VALUE
$2,000 - $10,000 $10.001 - $100,000
$100,001 - $1,000,000 Over $1,000,000
NATURE OF INVESTMENT
Stock Other
(Describe)
Partnership Income Received of $0 - $499
;Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
_ $2,000 - $10,000 $1o,001 - $100,000
$100,001 - $1,000,000 I Over $1,000,000
NATURE OF INVESTMENT
Stock Other
escn a
Partnership i Income Received of $0 - $499
I Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
ACQUIRED DISPOSED
FPPC Form 700 - Schedule A-1 12021/2022)
advice@fppe.ca.gov a 866-275-3772 o w .fppe.ca.gov
Page - 7
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
HR GREEN PACIFIC INC.
ADDRESS (Business Address Acceptable)
1260 CORONA POINTE COURT, SUITE 305
BUSINESS ACTIVITY, IF ANY, OF SOURCE
ENGINEERING & MANAGMENT CONSULTING
YOUR BUSINESS POSITION
VICE PRESIDENT
GROSS INCOME RECEIVED No Income - Business Position Only
$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
(For sett -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 I Rental Income, /let each source of $10,000 or more
Other
(Describe)
(Describe)
Name
GEORGE ANDREW WENTZ
NAME OF SOURCE OF INCOME
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF SOURCE
YOUR BUSINESS POSITION
GROSS INCOME RECEIVED No Income - Business Position Only
!, $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
(For self-employed use Schedule A-2.)
Partnership (Less than 10% ownership. For 10% or greater use
Schedule A-2.)
Sale of
(Reel property, car, boat, etc.)
Loan repayment
Commission or Rental Income, list each source of $to." or more
I I Other
(Describe)
" You are not required to report loans from a commercial lending institution, 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/Yeam)
% I None
SECURITY FOR LOAN
I None Personal residence
I Real Property
Street address
City
I Guarantor
Other
(DeswibeJ
Fl Form 700 - Schedule[ (2021/2022)
advice®fppc.ca.gov a 866-275-3772 a www.fppc.ca.gov
Page -13