700 NAI Consulting (Nickerson, J) 2020STATEMENT OF ECONOMIC INTERESTS Date IrMi Fr lYWRe(_
Filing Crlicr�l U�,- On!y
COVER PAGE MAR 10 2021
A PUBLIC DOCUMENT
Please type or print in ink. CITY OF LA (2)JINTA
NAME OF FILER (LAST) (FIRST) (MIDDLE)
Nickerson Joshua Richard
1. Office, Aqencv, or Court
Agency Name (Do not use acronyms)
City of La Quinta
Division, Board, Department, District, if applicable
Your Position
Contract Project Manager
► 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)
All Annual: The period covered is January 1, 2020, through
December 31, 2020.
.or -
The period covered is I I through
December 31, 2020.
❑ Assuming Office: Date assumed I I
❑ Candidate: Date of Election
4. Schedule Summary (must complete)
Schedules attached
Position:
❑ Judge, Retired Judge, Pro Tern Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left I I
(Check one circle.)
Q The period covered is January 1, 2020, through the date of
leaving office.
.or-
0 The period covered is I I through
the date of leaving office.
_ and office sought, if different than Part 1:
► Total number of pages including this cover page: 3
■❑ 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)
❑E— 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
DAYTIME TELEPHONE NUMBER EMAIL ADDRESS
( 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 3/2/2021 _ Signature
(month, day, year)
FPPC Form 700 - Cover Page (2020/2021)
advice@fppc.ca.gov - 866-275-3772 - www.fppc.ca.gov
Page - 5
SCHEDULE A-1
Investments
Stocks, Bonds, and Other Interests FNa
(Ownership Interest is Less Than 10%)
Investments must be itemized. Joshua Richard Nickerson
Do not attach brokerage or financial statements.
► NAME OF BUSINESS ENTITY
NAI Consulting, Inc.
GENERAL DESCRIPTION OF THIS BUSINESS
Civil Engineering Firm
FAIR MARKET VALUE
❑ $2,000 - $10,000 $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT Shareholder
❑ Stock Other
(Describe)
❑ Partnership Q Income Received of $0 - $499
0 Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
1 /20 /20
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,D01 - $1.000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership 0 Income Received of $0 - $499
0 Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
— / /20 1/2
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 0 Income Received of $0 - $499
0 Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
1 /20 1 /20
ACQUIRED DISPOSED
Comments:
► 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 0 Income Received of $0 - $499
0 Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
1 /20 1 /20
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 0 Income Received of $0 - $499
0 Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
� /20 1 /20
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
escrioe)
❑ Partnership 0 Income Received of $0 - $499
0 Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
1 /20 1 /20
ACQUIRED DISPOSED
FPPC Form 700 - Schedule A-1(2020/2021)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page - 7
SCHEDULE C
Income, Loans, & Business
Positions
(Other than Gifts and Travel Payments)
NAME OF SOURCE OF INCOME
NAI Consulting
ADDRESS (Business Address Acceptable)
68955 Adelina Road, Cathedral City, CA 92234
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Civil Engineering Project Management
YOUR BUSINESS POSITION
Senior Engineer
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 or $10,000 or more
(Describe)
Name
Joshua Richard Nickerson
NAME OF SOURCE OF INCOME
Dudek
ADDRESS (Business Address Acceptable)
78075 Main Street, Suite G-203, La Quinta, CA
BUSINESS ACTIVITY, IF ANY, OF SOURCE
Environmental Consulting
YOUR BUSINESS POSITION
Environmental Planner
GROSS INCOME RECEIVED ❑ No Income - Business Position Only
❑ $500 - $1,000 ❑ $1,001 - $10,000
Q $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) (Describe)
mo. 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 - Schedule C (2020/2021)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov
Page -13