700 NV5 (Fahrion) 2022STATEMENT OF ECONOMIC INTERESTS DatR it ECEIVEPd
Filing Use Only
COVER PAGE MAR 2 9 2023
A PUBLIC DOCUMENT
Please type or print in ink. CITY OF LA QUINTA
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Fahrion Jay S
1. Office, Agency, or Court
Agency Name (uo not use acronyms)
NV5, Inc.
Division, Board, Department, District, if applicable
Your Position
Consultant
► If 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
❑ Multi -County
City of La Quinta
3. Type of Statement (Check at least one box)
�■ Annual: The period covered is January 1, 2022, through
December 31, 2022.
.or -
The period covered is
December 31, 2022.
❑ Assuming Office: Date assumed
❑ Candidate: Date of Election
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left I I
(Check one circle.)
through ❑ The period covered is January 1, 2022, through the date of
leaving office.
.or-
[_1 The period covered is I I through
the date of leaving office.
and office sought, if different than Part 1:
Schedule Summary (required) ► Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 - Investments - schedule attached ❑ 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
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
Palm Desert CA 92211
DAYTIME TELEPHONE NUMBER EMAILADDRESS
( iay.fahrian(@nv5.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 forego' g is t d correct.
700 - Cover Page (2022/2023)
advice@fppc.ca.gov - 866-275-3772 - www.fppc.ca.gov
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