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HomeMy WebLinkAboutBill McLean /~fP~cco~cyixn,l Warren C. Hurren, C.A. Neil Sinclair, B.B.A., C.A. Don MacIntyre, B MATH, C.A. August 10, 2011 Campaign of Bill McLean 1659 Goldenridge Road Pickering, Ontario L1V 7J5 Dear Mr. McLean: We are pleased to enclose herewith three copies of the Financial Statement - Form 4. As your campaign period was extended, this report covers the period from January 6, 2010 to June 30, 2011. This report includes all financial transactions previously reported upon in the initial filing as well as the transactions from January 1, 2011 to June 30, 2011. As the campaign contributions and the expenses are still less than $10, 000, an audit report is still not required. There is a surplus of $363.55. This is to be paid to the Clerk of the City of Pickering. This supplementary filing is to be filed with the Clerk by 2:00 p.m. on Friday September 30, 2011. We trust that you will find the foregoing in order. Sincerely, HURREN, SINCLAIR, MACINTYRE CHARTERED ACCOUNTANTS Neil Sinclair, B. A., Licensed Public Accountant 1-16306 N S/kh Encl. P.O. BOX 458 PICKERING, ONTARIO L1 V 2R7 TEL: (905) 683-8856 FAX: (905) 683-3428 raj. Ontario Ministry of Municipal Affairs Financial Statement - Auditor's Report and Housing Form 4 Municipal Elections Act. 1996 (Section 78) Instructions All candidates must complete Boxes A, B, C, D, E and F and Schedule 1. All candidates must complete Schedules 2, 3 and 4 as appropriate. Candidates who receive contributions or incur expenses in excess of $10,000 must also attach an Auditor's Report. All surplus funds (after any refund to the candidate or his or her spouse) shall be paid immediately over to the clerk who was responsible for the conduct of the election. YYYY MM DD YYYY MM DD For the campaign period from (day candidate filed nomination) 2010 01 06 to 2011 06 30 ❑ Primary filing reflecting finances to December 31 (or 45t" day after voting day in a by-election) ® Supplementary filing including finances after December 31 (or 45ti' day after voting day in a by-election) Box A: Name of Candidate and Office Name of Candidate Last Name First Name Middle Initial McLean Bill R Mailing Address Suite/Unit No. Street No. Street Name 1659 Goldenridge Rd City/Town Province Postal Code Pickering ON L1 V 7J5 Telephone No. (incl. area code) Fax No. Email Address Business Home 416-567-1055 905-839-9177 bmclean(-qlcityofpjckering.com Name of office for which the candidate sought election Ward Name or No. (if any) Regional Councillor Ward 2 Name of Municipality Pickering Box B: Summary of Campaign Income and Expenses 1. My spending limit (as issued by clerk) was - - - - - - - - - - - - - - - - - - - - $ 19,154.20 2. Surplus (or deficit) from previous election - - - - - - - - - - - - - - - - - - - - $ 103.21 3. Total contributions received (from Schedule 1) - - - - - - - - - - - - - - - - - - - $ 7,150.0() 4. My total campaign expenses that were subject to the spending limit were (from Box C) - - - $ 5,882.45 5. My total campaign expenses that were not subject to the spending limit were (from Box C) - $ 904.00 6. Total of all campaign expenses (from Box C) - - - - - - - - - - - - - - - - - - - 6,786.45 7. Election campaign surplus/deficit from current election (from Box E) - - - - - - - - - - $ 363.55 8. Contributions refunded to candidate or spouse (from Box E) - - - - - - - - - - - - - 0.00 9. Amount paid to clerk (from Box E) - - - - - - - - - - - - - - - - - - - - - - - 363.55 9503P (2010101) C Queen's Printer for Ontario 2010 Disponibte en frangais Page 1 of 8 Box C: Statement of Campaign Period Income and Expenses From To For Candidate YYYY MM DD YYYY MM DD 2010 01 06 2011 06 30 Bill McLean INCOME Candidate's surplus from immediately preceding election released by the clerk + $ 0.00 Contributions from candidate - - - - - - - - - - - - - - - - - - + $ 0.00 Contributions from spouse of candidate - - - - - - - - - - - - - - + $ 0.0() All other contributions - - - - - - - - - - - - - - - - - - - - - + $ 7,150.00 Revenue from fund-raising functions not deemed a contribution (from Schedule 2, Part III) - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Interest income - - - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Other (provide full details) 1. +'i$ 2. - 3. + i$ Total Campaign Period Income - - - - - - - - - - - - - - - - - - - - - - - - - - _ Is 7,150.00 C1 EXPENSES (Note: include the value of contributions of goods and services) Expenses Subject to Spending Limit Advertising - - - - - - - - - - - - - - - - - - - - - - - - + $ 945%.77 Bank charges - - - - - - - - - - - - - - - - - - - - - - - + $ 169.71 Brochures - - - - - - - - - - - - - - - - - - - - - - - - + $ 1,80246 1 Interest on loan - - - - - - - - - - - - - - - - - - - - - - + $ Inventory contributed to candidate's campaign (Schedule 3) - - - - - - + $ Meetings hosted - - - - - - - - - - - - - - - - - - - - - - + - $ Nomination filing fee - - - - - - - - - - - - - - - - - - - - - + $ 100.00 Office expenses - - - - - - - - - - - - - - - - - - - - - - + $ 2,157.05 Phone and/or Internet - - - - - - - - - - - - - - - - - - - - + $ Salaries and benefits/honoraria/professional fees - - - - - - - - - + $ Signs - - - - - - - - - - - - - - - - - - - - - - - - - - + . $ Other (provide full details) 1. Meals + $ 707.46 2. + $ 3. + $ Subtotal - - - - - - - - - - - - - - - - - - - - - - - - - - 5,882.45 C2 Expenses Not Subject to Spending Limit Accounting and audit - - - - - - - - - - - - - - - - - - - - + $ 904.00 Costs of fund-raising function (from Schedule 2, Part IV) - - - - - - - - + $ Expenses related to compliance audit - - - - - - - - - - - - - - + $ Expenses related to controverted elections - - - - - - - - - - - - + $ Expenses related to recounts - - - - - - - - - - - - - - - - - + $ Voting day party / appreciation notices - - - - - - - - - - - - - - + $ Expenses related to candidate's disability (provide details) 1. + $ 2. + $ 3. + I$ Other (provide full details) 1. + $ 2. + 3. +I Subtotal - - - - - - - - - - - - - - - - - - - - - - - - - - _ Is 904.00 C3 Total Campaign Period Expenses (C2) + (C3) - - - - - - - - - - - - - - - - - - - - - _ Is 6,786.45 C4 Excess (Deficiency) of Income over Expenses (Cl) - (C4) - - - - - - - - - - - - - - - - _ $ 363.55 9503P (2010101) Page 2 of 8 Box D: Statement of Assets and Liabilities as at December 31 , 2010 Assets Cash - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ 974.76 Accounts receivable - - - - - - - - - - - - - - - - - - - - - + $ 1,500.00 Value of inventory retained (from Schedule 4) - - - - - - - - - - - - + $ Other (provide full details) 1. + $ 2. + $ 3. + $ Total Assets - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ Is 2,474.76 Liabilities and Excess (Deficiency) of Income over Expenses Accounts payable - - - - - - - - - - - - - - - - - - - - - - - + $ 2,111.2 1 Borrowings, overdraft - - - - - - - - - - - - - - - - - - - - - + $ Other (provide full details) 1. + $ 2. + $ 3. _ + $ Total Liabilities - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ $ 2,111.21 Box E: Statement of Determination of Surplus or Deficit and Disposition of Surplus Part I - Determination of Surplus or Deficit Amount of excess (deficiency) of income over expenses (from Box C) - - - - - - - - - - - - - + . $ 363.55 E1 Deduct: Any deficit carried forward by the candidate from immediately preceding election if the offices are with respect to the same jurisdiction - - - - - - - - - - - - - - - - - $ E2 Surplus (or deficit) for the campaign period (E1) - (E2) - - - - - - - - - - - - - - - - - - - = 'S 363.55 Deduct: Any refund of contributions to the candidate or spouse (only if there is a surplus) - - - - - - - $ 0.00 Total Determination - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ Is 363.55 E3 Part II - Disposition of Surplus If line E3 shows a surplus, the amount must be paid in trust, at the time the financial statements are filed, to the municipal clerk who was responsible for the conduct of the election. Surplus paid to the municipal clerk of the municipality of Pickering Box F: Declaration L e clt a candidate in the municipality of C- e--r- i V--~ a , hereby declare that to the best of my knowledge and belief that these financial statements and attached supporting schedules are true and correct. Declared before (clerk or commissioner) in the C, p~ P 1 C.``K{_t-L wc. on (yyyy/mm/dd) 20 t 1 /6 8 1[ 5 b . Signature of Clerk or Commissioner Signature of Candidate ao I. I l O S ! t5 DEBBIE M. SHIELDS, CITY CLERK, Date Filed in the Clerk's Office (yyyy/mm/dd) CITY OF PICKERING, EX OFFICIO COMMISSIONER PURSUANT TO SECTION 1121 OF THE COMMISSIONERS FOR TAKING AFFIDAVITS ACT. 9503P (2010101) Page 3 of 8 Schedule 1 - Contributions Part I - Contribution Contribution from candidate - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Contribution from spouse - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Total from each single contributor totalling more than $100 • include all ticket revenue where ticket price exceeds $100 • include all goods and services where value exceeds $100' • do not include contributions from candidate or spouse - - - - - - - - - - - - - - - + $ 7,150.00 Total from each single contributor totalling $100 or less • include all ticket revenue where ticket price is $100 or less • include all goods and services where value is $100 or less* • do not include contributions from candidate or spouse - - - - - - - - - - - - - - - + $ 0.00 *Note: Goods and services must also be reported as expenses in Box C Less: Contribution returned or payable to the contributor - - - - - - - - - - - - - - - - - - $ Contribution paid or payable to the clerk - - - - - - - - - - - - - - - - - - - - - - $ 1A 7,150.00 Total Amount of Contribution - - - - - - - - - - - - - - - - - - - - - - - - - - - _ Is Total contribution from anonymous sources - - - - - - - - - - - - - - - - - - - - - - $ 1 B Amount of contributions paid or payable to the clerk (1A) + (16) - - - - - - - - - - - - - - - _ S Part II - List of Contributions from Each Single Contributor Totalling More than $100 Table 1: Monetary contributions from individuals other than candidate or spouse Name Address Amount Steve De Guise 139 Indian Lake Road RR 1.. Elgin, Ontario, KOG lEO $ 750.00 Andrew Di Lorenzo 18-68 Millwick Drive. North York, Ontario. N19L lY3 $ 500.00 Nick Di Lorenzo 18-68 Millwick Drive, North York. Ontario. M91- 1Y3 $ 500.00 Kenneth Rovinelli 1163 Old Post Drive, Oakville, Ontario. L6M IA5 $ 750.00 I Petrovich 24 BeasleN Drive, Richmond Hill. Ontario. L4C V2 $ 750.00 is Is $ I$ I$ $ ❑ Additional information is listed on separate supplementary attachment Total $ 3,250.00 9503P (2010101) Page 4 of 8 Table 2: Monetary contributions from unions or corporations Name (Legal and Carrying on Address President or Cheque Signatory Amount Business As) Business Manager The Bench Press Ltd 2402 Stouffville Road RR 1 O/A Creative Outdoor 402 St v. ON LOH ] GO David R Gray Liz Gayford $ 750.00 Gormle Advertising Picore Holdings Ltd 80 Queen Street Kim Donovan Kim Donovan $ 750.00 Kingston, ON K7K 6W7 Moroan's Port Restaurant 1289 Wharf Stret Todd Morgan Ralph Morgan $ 750.00 Inc Pickering, ON L1 W 1 A2 Toronto Police 180 Yorkland Blvd Mike McCormide Tom Foulds $ 750.00 Association Toronto, ON M2.1 1 RS International Brotherhood 80 Lake Road, Unit 3 of Electrical Workers Bowmanville. ON L1C 4P8 Randy O'Neill Randy O'Neill $ 400.00 Local 894 Bayfield Realty Advisors 2300 Yonge Street #904 Harold Spring Harold Spring $ X00.00 Inc Toronto, ON M4P 1 E4 ` 2143087 Ontario (AHK 2985 Drew Rd Palwinder Singh Palwinder Singh Group) Mississauga. ON L4T OA4 Verraich Verraich $ 150.00 ® Additional information is listed on separate supplementary attachment Total $ 3,750.00 Table 3: Contributions in goods or services (Note: must also be reported as expenses in Box C) Name Address Goods or Services Amount $ - I 1$ ❑ Additional information is listed on separate supplementary attachment Total $ Total Part II Contributions $ 9503P (2010101) Page 5 of 8 Schedule 2 - Fund-Raising Function ❑ Additional schedule for each event or activity held is/are listed on separate supplementary attachment(s) Date Description of event or activity YYYY MM DD Admission charge (per person)" (may not exceed individual contribution limit) - - - - - - - - - - $ 2A *If admission charge per person is not consistent, attach complete breakdown of all ticket sales. Number of tickets sold - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 12B Part I - Ticket Revenue Lines: (2A) x (21113) (include in Schedule 1) - - - - - - - - - - - - - - - - - - - - - - - - _ IS Part II - Other Revenue Deemed A Contribution Provide full details (e.g., revenue from goods sold in excess of fair market value) 1. _ - - - + $ 2. 3. - - - + $ 4. - - - + $ 5. ---+I$ 6. - - - + $ 7. - - - + $ 8. - - - + $ Total Part II Revenue (include in Schedule 1) - - - - - - - - - - - - - - - - - - - - - - _ I S Part III - Other Revenue Not Deemed A Contribution Provide full details (e.g., contributions of $10 or less; revenue from refreshment sold at cost) 1. 2. - - - + $ 3. + $ 4. - - - + $ 5. 6. - - - + $ 7. - - - + $ 8. - - + Total Part III Revenue (include in Box C) - - - - - - - - - - - - - - - - - - - - - - = IS - Part IV - Expenses Related to Fund-Raising Function Venue - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ - Event advertising - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Food and drink - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Entertainment - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Other (provide full details) 1. - - + $ 2. - - - + $ 3. - - - + $ 4. - - + 5. - - - + $ 6. - - - + $ 7. - - - + $ 8. - - - - ---+I$ Total Part IV Expenses (include in Box C) - - - - - - - - - - - - - - - - - - - - - - - _ Is 9503P (2010101) Page 6 of 8 Schedule 3 - Inventory of Campaign Goods and Materials (from Previous Campaign) Used in Candidate's Campaign Description Date Acquired Supplier Unit Value Quantity Total Value (yyyy/mm/dd) i$ I $ I $ I$ Total Value of Inventory from Previous Campaign Used in Candidate's Campaign $ Schedule 4 - Inventory of Campaign Goods and Materials at The End of Campaign Description Date Acquired Supplier Unit Value Quantity Total Value (yyyy/mm/dd) i i $ $ i i $ $ Total Value of Inventory of Campaign Goods and Materials $ 9503P (2010101) Page 7 of 8 Auditor'-s Report Municipal Elections Act, 1996 (Section 78) A candidate who has received contributions or incurred expenses in excess of $10,000 must attach an auditor's report. The report must be done in accordance with generally accepted auditing standards and must: • set out the scope of the examination • provide an opinion as to the completeness and accuracy of the financial statement and whether it is free of material misstatement Professional Designation of Auditor Municipality Date (yyyy/mm/dd) Contact Person Licence No. Last Name First Name Address Suite/Unit No. Street No. Street Name City/Town Province Postal Code Telephone No. (incl. area code) Fax No. Email Address ext. 9503P (2010/01; Page 8 of 8 Table 2 -Monetary Contributions from unions or corporations - supplementary list NAME ADDRESS President Cheque Amount or Signatory Business Manager Durham Region 74 Anders Drive Heavy Port Perry, ON Wayne Bruce Wayne Bruce $ 150.00 Contractors L9L 1T5 Lvnne Siset Association Total e-V'W~ l l Warren C. Hurren, C.A. Neil Sinclair, B.B.A., C.A. Don MacIntyre, B MATH, C.A. March 9, 2011 Mr. Bill McLean 1659 Goldenridge Road Pickering, Ontario LIV 7J5 Dear Mr. McLean: Please find enclosed two copies of the Financial Statement - Form 4 reporting the contributions and expenses pertaining to the 2010 municipal campaign. This report covers the period from January 6, 2010 to December 31, 2010. This report must be signed on page 3 in the presence of the Clerk prior to 2:00 p.m. on March 25, 2011. Sincerely, HURREN, SINCLAIR, MACINTYRE CHARTERED ACCOUNTANTS Neil Sinclair, B. vC.A. Licensed Public Accountant 1-16306 NS/kh Encl. P.O. BOX 458 PICKERING, ONTARIO L1 V 2R7 TEL: (905) 683-8856 FAX: (905) 683-3428 t)'~Ontario Ministry of Municipal Affairs and Housing Financial Statement - Auditor's Report Form 4 Municipal Elections Act, 1996 (Section 78) Instructions All candidates must complete Boxes A, B, C, D, E and F and Schedule 1. All candidates must complete Schedules 2, 3 and 4 as appropriate. Candidates who receive contributions or incur expenses in excess of $10,000 must also attach an Auditor's Report. All surplus funds (after any refund to the candidate or his or her spouse) shall be paid immediately over to the clerk who was responsible for the conduct of the election. YYYY MM DD YYYY MM DD For the campaign period from (day candidate filed nomination) 12010 .01 06 to 2010 12 31 ® Primary filing reflecting finances to December 31 (or 45`h day after voting day in a by-election) ❑ Supplementary filing including finances after December 31 (or 45`h day after voting day in a by-election) Box A: Name of Candidate and Office Name of Candidate Last Name First Name Middle Initial McLean Bill R Mailing Address Suite/Unit No. Street No. Street Name 1659 Goldenridge Rd City/Town Province Postal Code Pickering ON L 1 V 7J5 Telephone No. (incl. area code) Fax No. Email Address Business Home 416-567-1055 905-839-9177 bmclean@cityofpickering.com Name of office for which the candidate sought election Ward Name or No. (if any) Regional Councillor Ward 2 Name of Municipality Pickering Box B: Summary of Campaign Income and Expenses 1. My spending limit (as issued by clerk) was - - - - - - - - - - - - - - - - - - - - Is 19,154.20 2. Surplus (or deficit) from previous election - - - - - - - - - - - - - - - - - - - - $ 103.21 3. Total contributions received (from Schedule 1) - - - - - - - - - - - - - - - - - - - 4,650.00 4. My total campaign expenses that were subject to the spending limit were (from Box C) - - - Is 5,822.75 5. My total campaign expenses that were not subject to the spending limit were (from Box C) - - Is 565.00 6. Total of all campaign expenses (from Box C) - - - - - - - - - - - - - - - - - - - $ 6,387.75 7. Election campaign surplus/deficit from current election (from Box E) - - - - - - - - - - $ (1,737.75) 8. Contributions refunded to candidate or spouse (from Box E) - - - - - - - - - - - - - 0.00 9. Amount paid to clerk (from Box E) - - - - - - - - - - - - - - - - - - - - - - - I 0.00 9503P (2010/01) © Queen's Printer for Ontario, 2010 Disponible en franrais Page 1 of 8 Box C: Statement of Campaign Period Income and Expenses From To For Candidate YYYY MM DD YYYY MM DD 2010 01 06 2010 12 31 Bill McLean INCOME Candidate's surplus from immediately preceding election released by the clerk + $ 0.00 Contributions from candidate - - - - - - - - - - - - - - - - - - + $ 0.00 Contributions from spouse of candidate - - - - - - - - - - - - - - + $ 0.00 All other contributions - - - - - - - - - - - - - - - - - - - - - + $ 4,650.00 Revenue from fund-raising functions not deemed a contribution (from Schedule 2, Part III) - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Interest income - - - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Other (provide full details) 1. + $ 2 + $ 3. + $ Total Campaign Period Income - - - - - - - - - - - - - - - - - - - - - - - - - - _ $ 4,650.00 C1 EXPENSES (Note: include the value of contributions of goods and services) Expenses Subject to Spending Limit Advertising - - - - - - - - - - - - - - - - - - - - - - - - + $ 945.77 Bank charges - - - - - - - - - - - - - - - - - - - - - - - + $ 1 10.01 Brochures - - - - - - - - - - - - - - - - - - - - - - - - + $ 1,802.46 Interest on loan - - - - - - - - - - - - - - - - - - - - - - + $ Inventory contributed to candidate's campaign (Schedule 3) - - - - - - + $ Meetings hosted - - - - - - - - - - - - - - - - - - - - - - + $ Nomination filing fee - - - - - - - - - - - - - - - - - - - - - + $ 100.00 Office expenses - - - - - - - - - - - - - - - - - - - - - - + $ 2,157.05 Phone and/or Internet - - - - - - - - - - - - - - - - - - - - + $ Salaries and benefits/honoraria/professional fees - - - - - - - - - + $ Signs - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Other (provide full details) 1. Meals + $ 707.46 2 + $ 3. + $ Subtotal - - - - - - - - - - - - - - - - - - - - - - - - - - _ $ 5,822.75 C2 Expenses Not Subject to Spending Limit Accounting and audit - - - - - - - - - - - - - - - - - - - - + $ 565.00 Costs of fund-raising function (from Schedule 2, Part IV) - - - - - - - - + $ Expenses related to compliance audit - - - - - - - - - - - - - - + $ Expenses related to controverted elections - - - - - - - - - - - - + $ Expenses related to recounts - - - - - - - - - - - - - - - - - + $ Voting day party / appreciation notices - - - - - - - - - - - - - - + $ Expenses related to candidate's disability (provide details) 1. + $ 2. + $ 3. + $ Other (provide full details) 1. + $ 2. + $ 3. + $ Subtotal - - - - - - - - - - - - - - - - - - - - - - - - - - _ $ 565.00 C3 Total Campaign Period Expenses (C2) + (C3) - - - - - - - - - - - - - - - - - - - - - _ Is 6,387.75 C4 Excess (Deficiency) of Income over Expenses (C1) - (C4) - - - - - - - - - - - - - - - - _ $ 1,737.75 Page 2 of 8 9503P (2010/01) Box D: Statement of Assets and Liabilities as at December 31 , 2010 Assets Cash - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ 533.65 Accounts receivable - - - - - - - - - - - - - - - - - - - - - + $ Value of inventory retained (from Schedule 4) - - - - - - - - - - - - + $ Other (provide full details) 1. + $ 2 + $ 3. + $ Total Assets - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ 533.65 Liabilities and Excess (Deficiency) of Income over Expenses Accounts payable - - - - - - - - - - - - - - - - - - - - - - - + $ 2,271.40 Borrowings, overdraft - - - - - - - - - - - - - - - - - - - - - + $ Other (provide full details) 1. + $ 2 + $ 3. + $ Total Liabilities - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ $ 2,271.40 Box E: Statement of Determination of Surplus or Deficit and Disposition of Surplus Part I - Determination of Surplus or Deficit Amount of excess (deficiency) of income over expenses (from Box C) - - - - - - - - - - - - - + $ (1,737.75) E1 Deduct: Any deficit carried forward by the candidate from immediately preceding election $ E2 if the offices are with respect to the same jurisdiction - - - - - - - - - - - - - - - - _ Surplus (or deficit) for the campaign period (E1) - (E2) - - - - - - - - - - - - - - - - - - - = $ (1,637.75) Deduct: Any refund of contributions to the candidate or spouse (only if there is a surplus) - - - - - - - $ 0.00 Total Determination - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ $ (1,637.75) E3 Part II - Disposition of Surplus If line E3 shows a surplus, the amount must be paid in trust, at the time the financial statements are filed, to the municipal clerk who was responsible for the conduct of the election. Surplus paid to the municipal clerk of the municipality of Box F: Declaration a candidate in the municipality of P ck~ r r G hereby declare that to the best of my knowledge and belief that these financial statements and attached supporting schedules are true and correct. Declared before (clerk or commissioner)( in the C,~ O-~ P1 GKer i ~G on (yyyy/mm/dd) 20 l i 3 1 1 Signature of Clerk or Commissioner Signature of Candidate OOlr /03/ l t Date Filed in the Clerk's Office (yyyy/mm/dd) DEBBIE M. SHIELDS, CITY CLERK, CITY OF PICKERING, EX OFFICIO COMMISSIONER PURSUANT TO SECTION 90 OF THE COMMISSIONERS FOR TAKING AFFIDAVITS ACT. 9503P (2010/01) Page 3 of 8 Schedule 1 - Contributions Part I - Contribution Contribution from candidate - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Contribution from spouse - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ 0.00 Total from each single contributor totalling more than $100 • include all ticket revenue where ticket price exceeds $100 • include all goods and services where value exceeds $100" • do not include contributions from candidate or spouse - - - - - - - - - - - - - - - + $ 4,650.00 Total from each single contributor totalling $100 or less • include all ticket revenue where ticket price is $100 or less • include all goods and services where value is $100 or less" 0.00 • do not include contributions from candidate or spouse - - - - - - - - - - - - - - + i $ "Note: Goods and services must also be reported as expenses in Box C Less: Contribution returned or payable to the contributor - - - - - - - - - - - - - - - - - - $ Contribution paid or payable to the clerk - - - - - - - - - - - - - - - - - - - - - - $ 1A Total Amount of Contribution - - - - - - - - - - - - - - - - - - - - - - - - - - - = $ 4,650.00 Total contribution from anonymous sources - - - - - - - - - - - - - - - - - - - - - - $ 1 B Amount of contributions paid or payable to the clerk (1A) + (1 B) - - - - - - - - - - - - - - - = $ Part II - List of Contributions from Each Single Contributor Totalling More than $100 Table 1: Monetary contributions from individuals other than candidate or spouse Name Address Amount Steve De Guise 139 Indian Lake Road RR 1, Elgin, Ontario, KOG 1 EO $ 750.00 ❑ Additional information is listed on separate supplementary attachment Total $ 750.00 9503P (2010/01) Page 4 of 8 Table 2: Monetary contributions from unions or corporations Name (Legal and Carrying on Address President or Cheque Signatory Amount Business As) Business Manager The Bench Press Ltd 2402 Stouffville Road RR 1 O/A Creative Outdoor Gormley, ON LOH 1GO David R Gray Liz Gayford $ 750.00 Advertising Picore Holdings Ltd 80 Queen Street Kim Donovan Kim Donovan $ 750.00 Kingston, ON K7K 6W7 Morgan's Port Restaurant 1289 Wharf Stret Todd Morgan Ralph Morgan $ 750.00 Inc Pickering, ON L1 W 1 A2 Toronto Police 180 Yorkland Blvd Mike McCormide Tom Foulds $ 750.00 Association Toronto, ON M2.1 1 R5 International Brotherhood 380 Lake Road Unit 3 of Electrical Workers Bowmanville, ON L1C 4P8 Randy O'Neill Randy O'Neill $ 400.00 Local 894 Bayfield Realty Advisors 2300 Yonge Street 4904 Harold Spring Harold Spring $ 200.00 Inc Toronto, ON M4P 1 E4 2143087 Ontario (AHK 2985 Drew Rd Palwinder Singh Palwinder Singh $ 150.00 Group) Mississauga, ON L4T OA4 Verraich Verraich ® Additional information is listed on separate supplementary attachment Total $ 3,750.00 Table 3: Contributions in goods or services (Note: must also be reported as expenses in Box C) Name Address Goods or Services Amount ❑ Additional information is listed on separate supplementary attachment Total $ Total Part II Contributions $ Page 5 of 8 9503P (2010/01) Schedule 2 - Fund-Raising Function ❑ Additional schedule for each event or activity held is/are listed on separate supplementary attachment(s) Date Description of event or activity YYYY MM DD Admission charge (per person)* (may not exceed individual contribution limit) - - - - - - - - - 2A *If admission charge per person is not consistent, attach complete breakdown of all ticket sales. Number of tickets sold - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 213 Part I - Ticket Revenue Lines: (2A) x (213) (include in Schedule 1) - - - - - - - - - - - - - - - - - - - - - - - - _ 1 $ Part II - Other Revenue Deemed A Contribution Provide full details (e.g., revenue from goods sold in excess of fair market value) 1 - - - + $ 2. - - - + $ 3. - - - + $ 4. - - - + $ 5. - - - + $ 6. - - - + $ 7. - - - + $ 8. - - - + $ Total Part II Revenue (include in Schedule 1) - - - - - - - - - - - - - - - - - - - - - - _ $ Part III - Other Revenue Not Deemed A Contribution Provide full details (e.g., contributions of $10 or less; revenue from refreshment sold at cost) 1. - - - + $ 2. - - - + $ 3. - - - + $ 4. - - - + $ 5. - - - + $ 6. - - - + $ 7. - - + $ 8. - - - + $ Total Part III Revenue (include in Box C) - - - - - - - - - - - - - - - - - - - - - - - - _ $ Part IV - Expenses Related to Fund-Raising Function Venue - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Event advertising - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Food and drink - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Entertainment - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $ Other (provide full details) 1. - - + $ 2. - - - + $ 3. - - - + $ 4. - - - + $ 5. - - - + $ 6. - - - + $ 7. - - - + $ 8. - - - + $ Total Part IV Expenses (include in Box C) - - - - - - - - - - - - - - - - - - - - - - - _ $ 9503P (2010/01) Page 6 of 8 Sdhedule 3 - Inventory of Campaign Goods and Materials (from Previous Campaign) Used in Candidate's Campaign Description Date Acquired Supplier Unit Value Quantity Total Value (yyyy/mm/dd) Total Value of Inventory from Previous Campaign Used in Candidate's Campaign $ Schedule 4 - Inventory of Campaign Goods and Materials of The End of Campaign Description Date Acquired Supplier Unit Value Quantity Total Value (yyyy/mm/dd) Total Value of Inventory of Campaign Goods and Materials $ 9503P (2010/01) Page 7 of 8 Auditor's Report Municipal Elections Act, 1996 (Section 78) A candidate who has received contributions or incurred expenses in excess of $10,000 must attach an auditor's report. The report must be done in accordance with generally accepted auditing standards and must: • set out the scope of the examination provide an opinion as to the completeness and accuracy of the financial statement and whether it is free of material misstatement Professional Designation of Auditor Municipality Date (yyyy/mm/dd) Contact Person Licence No. Last Name First Name Address Suite/Unit No. Street No. Street Name City/Town Province Postal Code Email Address Telephone No. (incl. area code) Fax No. ext. 9503P (2010/01) Page 8 of 8 Table 2 -Monetary Contributions from unions or corporations - supplementary list NAME ADDRESS President Cheque Amount or Signatory Business Manager Durham Region 74 Anders Drive Heavy Port Perry, ON Wayne Bruce Wayne Bruce $ 150.00 Contractors L9L 1T5 Lynne Siset Association Total S.3 IM i I Ministry of Municipal Affairs Notice of Extension of Campaign Ontario and Housing Period - Form 6 Municipal Elections Act, 1996 (Sections 68, 82.1) Instructions • To be completed and filed with the clerk by candidates or registrants requesting an extension of the campaign period due to a deficit. • This notice must be filed on or before December 31 in the year of a regular election and 45 days after voting day in the case of a by-election. Name of Candidate and Office/Registrant and Question Name of Candidate/Registrant Last Name First Name Middle ;1(71 Mailing Address Suite/Unit No. Street No. Street Nam I N, /Z 106e Clty/TowPI Province Postal Code Telephone No. (incl. area code) Fax No. Email Address Business Home r/ Name of office for which the candidate sought election or the Ward name or no. (if any) question which the registrant incurred expenses Name of Municipality Declaration I, LcC, is the candidate/registrant mentioned above hereby give notice and declare to the clerk that I have a deficit and wish the campaign period to be extended in accordance with section 68. Declared before me at the C of P; G - V-, G in the R~ o r~ of this day of p c G vr.~o~ r 20 to Signature of Clerk Signature of Candidate/Registrant oa 20~o Zo_ 2 Date (yyyy/mm/dd) Date (yyyy/mm/dd) 10550P (2010/01) © Queen's Printer for Ontario, 2010 Disponible en frangais