Form 700 HR Green Pacific 2019STATEMENT OF ECONOMIC INTERESTS gate Initial Filing Received
Official Use Only
COVER PAGE
Please type or print in ink. A PUBLIC DOCUMENT
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Wentz Wentz Andrew
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
CITY OF LA QUINTA
Division, Board, Department, District, if applicable Your Position
PROFESSIONAL SERVICES CONSULTANT
► 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)
0 Annual: The period covered is January 1, 2018, through
-or-
December 31, 2018.
The period covered is --I through
December 31, 2018.
❑ Assuming Office: Date assumed I
❑ Candidate: Date of Election
Position:
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left _l�l
(Check one circle.)
O The period covered is January 1, 2018, through the date of
-or- leaving office.
Q The period covered is through
the date of leaving office.
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
5. Verification
MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document)
1260 Corona Pointe Court, #305
X❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
CITY STATE ZIP CODE
Corona CA 92879
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 855 ) 900-4742 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 foregoiy)g is true and correct.
Date Signed 5/30/2019
(month, day, year)
Signature
signed paper
with your riling official.)
FPPC Form 700 (2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
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SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests
(Ownership Interest is Less Than 10%)
Investments must be itemized.
Do not attach brokeraae or financial statements.
► NAME OF BUSINESS ENTITY
CHARLES SCHWAB
GENERAL DESCRIPTION OF THIS BUSINESS
RETIREMENT ACCOUNTS
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 O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
!_—/ 18 18
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
HR GREEN INC.
GENERAL DESCRIPTION OF THIS BUSINESS
401 K
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
Q $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
® Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
/18 18
ACQUIRED DISPOSED
► 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
X❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on schedule C)
IF APPLICABLE, LIST DATE:
I / 18 _lam 18
ACQUIRED DISPOSED
Comments:
Name
GEORGE A. WENTZ
► 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
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule c)
IF APPLICABLE, LIST DATE:
I / 18 18
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
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
I / 18 J 18
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
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule Q
IF APPLICABLE, LIST DATE:
/ / 8 1—J 18
ACQUIRED DISPOSED
FPPC Form 700 (2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
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SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
HR GREEN CALIFORNIA, INC.
ADDRESS (Business Address Acceptable)
1260 Corona Pointe Cte., #305, Corona, CA 92879
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Engineering & Management Consulting
YOUR BUSINESS POSITION
Vice President
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
❑ $10,00, - $100,000 X❑ OVER $100,000
CONSIDERATION FOR WHICH INCOME WAS RECEIVED
XJ 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)
Name
GEORGE A. 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
(Real property, car, boat, etc.)
❑ Loan repayment
❑ Commission or ❑ Rental Income, list each source of $10,000 or more
❑ Other (Describe) I I ❑ Other
(Describe)
ll� 2. 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`
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 (MonthsNears)
% ❑ None
SECURITY FOR LOAN
❑ None ❑ Personal residence
❑ Real Property
❑ Guarantor
❑ Other
Street address
City
(Describe)
FPPC Form 700 (2018/2019)
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
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