CITY OF CHULA VISTA DISCLOSURE STATEMENT
Pursuant to Council Policy 101-01, prior to any action upon matters that will require discretionary action by the Council, Planning Commission and all other official bodies of the City of Chula Vista ( the " City"), a statementof disclosureof certain ownership or financial interests, payments, or campaigncontributions for a City election must be filed. The following information must be disclosed:
List the names of all persons having a financial interest in the property that is the subject of the application or the contract, e.g., owner, applicant, contractor, subcontractor, material supplier.
None
If any person* identified pursuantto item one (1) above is a corporation or partnership, list the names of all individuals with a two thousand dollars ($ 2, 000) investment in the business corporation/ partnership) entity.
None
3. If any person* identified pursuantto item one (1) above is a non-profit organization or trust, list the names of any person serving as director of the non- profit organization or as trustee or beneficiary or trustor of the trust.
None
4. Please identify every person, including any agents, employees, consultants, or independent contractors you have assigned to represent you before the City in this matter.
David A. Donnelly, Vice President
5. Has any person* associatedwith this contracthadany financial dealingswith an official** of the City as it relates to this contract within the past twelve ( 12) months? Yes No X N/ A
25 Q: I_Pr•ojectsLSTil10408 - Parentent Iajor Rehabilitation Program FI' 2021-221StrbntiiialsV00%LSTi1f0408 - Contract DocrmtentsacidSpecial Prorisions. docx
Rer. 31312023
f Yes, briefly describe the nature of the financial interest the official" may have in this contract.
6. Have you made a contribution of more than two hundred fifty dollars ($ 250) within the past twelve 12) months to a current member of the Chula Vista City Council? No X Yes _ If yes, which Council member?
Have you provided more than three hundred forty dollars ($ 340), or an item of equivalent value, to an official" of the City in the past twelve ( 12) months? ( This includes being a source of income, money to retire a legal debt, gift, loan, etc.) Yes _ No X If Yes, which official" and what was the nature of item provided? N/ A
Date: ' 5 II I
D+
Martin Marietta San Diego Aggregates LLC
dba ATP General Engineering Contractors
Name of Company, Firm or Entity
Signature of Contracto • pplicant
David A. Donnelly
Print or type name of Contractor/ Applicant
Vice President
Title
Person is defined as: any individual, firm, co -partnership, joint venture, association, social club, fraternal organization, corporation, estate, trust, receiver, syndicate, any other county, city, municipality, district, or other political subdivision, or any other group or combination acting as a unit.
Official includes, but is not limited to: Mayor, Council member, Planning Commissioner, Member of a board, commission, or committee of the City, employee, or staff members. 26 O: 1_ProjeclsMA, 10408 - Pavement Major Rehabilitation Progrm» FY2021- 2Mubmi1ta1sV 00% ISTiI ( 0408 - Contract Docunmenis and Special Provisions. docx
Rev. 31312023