700 NAI Consulting (Nickerson J.) 2022_ NIA _ STATEMENT OF ECONOMIC INTERESTS Date Initial Filing Received
FAIR POLITICAL PRACTICES COMMISSION COVER PAGE DECEIVED
A PUBLIC DOCUMENT
Please type or print in ink. MAR 2 3 2023
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Nickerson Joshua Richard CITY OF LA QUINTACITY CLESK DEPARTMENT
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable
► If filing for multiple positions, list below or on an attachment.
Agency:
Your Position
Contract Project Manager
(Do not use acronyms)
Position:
2. Jurisdiction of Office -(Check at least one box)
❑ State
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ Multi -County
❑ County of
ji. City of La Quinta
❑ Other
3. Type of Statement (Check at least one box)
❑■ Annual: The period covered is January 1, 2022, through
❑ Leaving Office: Date Left___J___J
December 31, 2022.
(Check one circle.)
-or-
The period covered is
through ❑ The period covered is January 1, 2022, through the date of
December 31, 2022.
-or- leaving office.
❑ Assuming Office: Date assumed I
❑ The period covered is I I through
the date of leaving office.
❑ Candidate: Date of Election and office sought, if different than Part 1:
4. Schedule Summary (required) ► Total number of pages including this cover page: 3
Schedules attached
❑ Schedule A-1 - Investments — schedule attached
E. Schedule C - Income, Loans, & Business Positions — schedule attached
❑■ Schedule A-2 - Investments — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule B - Real Property — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
-or- ❑ None - No reportable interests on any schedule
F Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
68955 Adelina Road Cathedral City CA 92234
DAYTIME TELEPHONE NUMBER EMAILADDRE-SS
(760 ) 323-5344 1 jnickerson@naiconsulting.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 Signature
fm . Cray, yeary )
FPPC Farm 700 - Cover Page (2022/2023)
advice@fppc.ca.gov - 866-275-3772 • www.fppc.ca.gov
Page - 5
SCHEDULE A-2
Investments, Income, and Assets
of Business Entities/Trusts
(Ownership Interest is 10% or Greater)
1. BUSINESS ENTITY OR TRUST
NAI Consulting, Inc.
Name
68955 Adelina Road, Cathedral City, CA 92234
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 J Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
Civil Engineering Firm
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
$0 - $1,999
$2,000 - $10,000 --j--j22 --j--j22
$10,001 - $100,000 ACQUIRED DISPOSED
$100,001 - $1,000,000
�^ Over $1,000,000
NATURE OF INVESTMENT S-Corp
❑ Partnership ❑ Sole Proprietorship C trier
YOUR BUSINESS POSITION Director
❑ $0 - $499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ❑ OVER $100,000
Q $1,001 - $10,000
3, LIST THE NAME OF ••RTABLE SINGLE SOURCE OF
INCOMEOF r err OR •
QNone or ❑ Names listed below
• INTERESTS IN REAL PROPERTY• OR
LEASED BY THE BUSINESS ENTITY OR
Checx one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
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
$100,001 - $1,000.000 ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
Name
Joshua Richard Nickerson
N� 1. BUSINESS ENTITY OR TRUST
Name
Address (Business Address Acceptable)
Check one
❑ Trust, go to 2 ❑ Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
II FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
$0 - $1,999
$2,000 - $10,000 --j--j22 --jJJ22
$10,001 - $100.000 ACQUIRED DISPOSED
$100,001 - $1,000,000
Over $1,000,000
NATURE OF INVESTMENT
❑ Partnership ❑ Sole Proprietorship ❑
Cher
[YOUR BUSINESS POSITION
GROSSii� 2. IDENTIFY THE • . (INCLUDE YOUR• RATA
SHARE OF •SS INCOME • THE ENTITY/TRUST)
❑_ $0 - $499 ❑ $10,001 - $100,000
$500 - $1,000 ❑ OVER $100,000
❑I $1,001 - $10,000
mi� 3. LIST THE NAME OF ••RTABLE SINGLE SOURCE OF
INCOMEOF rrr OR •
None or Names listed below
PROPERTY4. INVESTMENTS AND INTERESTS IN REAL • OR
LEASED BY THE BUSINESS ENTITY OR
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
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 if /22 --J_J22
$100,001 - $1,000,000 ACQUIRED DISPOSED
Over $1,000,000
NATURE OF INTEREST
❑ Property Ownership/Deed of Trust ❑ Stock ❑ Partnership
❑ Leasehold ❑ Other
Yrs. remaining
❑ Check box if additional schedules reporting investments or real property
are attached
Comments:
FPPC Farm 700 - Schedule A-2 (2022/2023)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 9
I
SCHEDULE C CALIFORNIA FORM
Income, Loans, & Business FAIR POLITICAL
Positions Name
(Other than Gifts and Travel Payments) Joshua Richard Nickerson
NAME OF SOURCE OF INCOME
NAI Consulting, Inc.
ADDRESS (Business Address Acceptable)
68955 Adelina Road, Cathedral City, CA 92234
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Civil Engineering Firm
YOUR BUSINESS POSITION
Director
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1.000 ❑ $1,001 - $10,OD0
❑ $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
(Real property, car, boat, etc)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other
(Describe)
(Describe)
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
(Real property, car, boat, etc)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of S10,000 or more
(Describe)
❑ 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' INTEREST RATE TERM (Months/Years)
ADDRESS (Business Address Acceptable)
BUSINESS ACTIVITY, IF ANY, OF LENDER
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
Street address
HIGHEST BALANCE DURING REPORTING PERIOD
❑ $500 - $1.000
❑ $1.001 - $10,000
❑ Guarantor
❑ $10,001 - $100,000
❑ OVER $100.000
❑ Other
Comments:
City
(Describe)
FPPC Form 700 - Schedule C (2022/2023)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 23