CITY OF CHULA VISTA DISCLOSURE STATEMENT
Pursuantto Council Policy 101-01, prior to any action upon mattersthat will require discretionary action bytheCouncil, PlanningCommissionandallotherofficialbodiesoftheCityof ChulaVista (the "City"), a statementof disclosure of certain ownership or financial interests, payments, or campaigncontributions for aCity electionmustbefiled. Thefollowinginformationmustbedisclosed:
List thenamesof all personshavinga financialinterestin thepropertythatis thesubjectof the applicationorthecontract, e.g., owner, applicant, contractor, subcontractor, materialsupplier.
Tim Schmid - President
James Wu - Vice President Secretary
Rick Yauney - Treasurer/ CFO
2. If anyperson* identifiedpursuantto itemone (1) aboveisa corporationorpartnership, listthe names of all individuals with a two thousand dollars ($ 2, 000) investment in the business corporation/ partnership) entity.
N/ A N/ A
3. If anyperson* identifiedpursuantto itemone (1) aboveisa non-profitorganizationortrust, list the names of any person serving as director of the non-profit organization or as trustee or beneficiary or trustor of the trust.
N/ A N/ A
4. Pleaseidentifyeveryperson, includingany agents, employees, consultants, or independent contractorsyouhaveassignedtorepresentyoubeforetheCity in thismatter.
Tim Schmid - President
James Wu - Vice President/ Secretary
Rick Yauney - Treasurer/ CFO
5. Hasanyperson* associatedwiththiscontracthadanyfinancialdealingswithanofficial** of the City asit relatesto thiscontractwithinthepasttwelve (12) months? Yes No X
N/ A N/ A
If Yes, briefly describethenatureof thefinancialinteresttheofficial** may have in this contract.
Re'. 1110712025
Haveyou madea contribution of more than two hundredfifty dollars ($250) within the past twelve 12) months to a current memberof the Chula Vista City Council? No _ Yes — If yes, which Council member?
NIA
7. Haveyou provided morethan threehundredforty dollars ($340), or an item of equivalent value, to an official** of the City in the pasttwelve ( 12) months? (This includes being a source of income, money to retire a legal debt, gift, loan, etc.) Yes _ No If Yes, which official** andwhat was the natureof item provided? h! A
Date: Is[g12 i
Applicant
Pavement Coatings Co. Jtaf t Wu
rNameof Company. Firm or Entity Priptr type name of Contractor/ Applicant Vice President/ Secretary
Title
Personis definedas: anyindividual, firm, co -partnership, joint venture, association, socialclub, fraternal organization, corporation, estate, trust, receiver, syndicate, any other county, city, municipality, district, or otherpolitical subdivision, or any other group or combination acting asa unit.
Official includes, but is not limited to: Mayor, Council member, Planning Commissioner, Member of aboard, commission, or committee of the City, employee, or staff members.
Rev. 1110712025