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700 NAI Consulting (Nickerson) 2023STATEMENT OF ECONOMIC INTERESTS COVER PAGE RECEIVED A PUBLIC DOCUMENT Please type or print in ink. 24 �y /� NAME OF FILER (LAST) (FIRST) (MIDDLE) APR 0 (W, Nickerson Joshua Richard CITY OF LA QUINTA 1. Office, Agency, or Court CITY CLERK DEPARTMENT Agency Name (Do not use acronyms) City of La Quinta Division, Board, Department, District, if applicable Your Position Contract Project Manager P. 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) State Multi -County ■ City of La Quinta 3. Type of Statement (Check at least one box) E. Annual: The period covered is January 1, 2023, through December 31, 2023. .or - The period covered is I I through December 31, 2023. Assuming Office: Date assumed Candidate: Date of Election Position: Judge, Retired Judge, Pro Tern Judge, or Court Commissioner (Statewide Jurisdiction) County of Other Leaving Office: Date Left ---J--J (Check one circle.) The period covered is January 1, 2023, through the date •or- of leaving office. The period covered is I I through the date of leaving office. and office sought, if different than Part 1: 4. Schedule Summary (required) ► Total number of pages including this cover page: 7j 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 -OP- None - No reportable interests on any schedule 5. 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 EMAIL ADDRESS ( 760 ) 323-5344 � inickerson )naiconsultina.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 3%ZS (File the originally signed paper statement with your filing official J FPPC Form 700 - Cover Page (2023/2024) 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) ll� 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 0 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 ��23 � /23 $10,001 - $100 000 ACQUIRED DISPOSED $100,001 - $1,000,000 ■ Over $1,000,000 NATURE OF INVESTMENT S-Corp Partnership Sole Proprietorship W. Other YOUR BUSINESS POSITION Director SHARE OF -•SS INCOME TO THE ENTITYITRUST) $0 - $499 ■ $10,001 - $100,000 $500 - $1,000 OVER $100.000 $1,001 - $10,000 ll� 3. LIST THE NAME OF •RTABLE SINGLE SOURCE OF INCOME OF $10,000 OR MORE (Attach a separate sheet it necessary.) None or ■ Names listed below City of La Quinta lii4. INVESTMENTS AND INTERESTS IN REAL PROPERTY .. LEASED BY THE BUSINESS ENTITY OR TRUST 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 --/�23 _/_/23 $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: CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION P, 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 FAIR MARKET VALUE IF APPLICABLE, LIST DATE $0 - $1,999 $2,000 - $10,000 /23 --J--J23 $10,001 - $100,000 ACQUIRED DISPOSED $100,001 - $1,000,000 Over $1,000,000 NATURE OF INVESTMENT Partnership Sole Proprietorship Other YOUR BUSINESS POSITION GROT55 111CUP. DE TLTIR• SHARE OF •SS INCOME • $0 - $499 $10,001 - $100,000 $500 - $1,000 OVER $100,000 $1.001 - $10,000 I� 3. LIST THE NAME OF ••RTABLE SINGLE SOURCE OF INCOMEOF $10,000 OR • None or Names listed below PROPERTYli� 4. INVESTMENTS AND INTERESTS IN REAL ..- LEASED BY THE BUSINESS ENTITY OR TRUST 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 _/ /23 --]---/23 $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 FPPC Form 700 -Schedule A-2 (2023/2024) advice@fppc.ca.gov • 866-275-3772 • wwwJppc.ca.gov Page - 9 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 - $10.000 $10,001 - $100,000 ■ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED IN 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, lost each source of $10.000 or more 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 $10,000 or more (Describe) Other I I Other (Describe) (Descnbe) 12. LOANS RECEIVED OR OUTSTANDING DURING THE REPORTING PERIOD * 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 (MonthsNears) 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: % None SECURITY FOR LOAN None Personal residence Real Property Guarantor Other Street address City (Describe) FPPC Form 700 - Schedule C (2023/2024) advice@fppc.ca.gov • 966-275-3772 • www.fppc.ca.gov Page - 13