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AGCPAC
Name (print) Office (if applicable) District (if applicable)
PO Box 10291, Reno, NV, 89510 7753296116
Mailing Address (include city and zip code) Telephone No.
melissad@nevadaagc.org
E-Mail Address

 Select Appropriate Box(es)
CANDIDATE PAC POL PRTY IND EXP NONPROFIT CORP
LEGAL DEFENSE FUND AMENDED LOCAL BAG
Annual Filing - Due January 15, 2010
Period: Jan 01, 2009 - Dec 31, 2009
Report #1 - Due June 01, 2010*
Period: Jan 01, 2010 - May 27, 2010
Report #2 - Due October 26, 2010*
Period: May 28, 2010 - Oct 21, 2010
Report #3 - Due January 15, 2011*/**
Period: Oct 22, 2010 - Dec 31, 2010
Annual Filing - Due January 15, 2011
Period: Jan 01, 2010 - Dec 31, 2010
FILE
Jan 15 2010
 
ROSS MILLER
SECRETARY OF STATE
FOR OFFICE USE ONLY
      * These Reports are filed by incumbents/candidates in the 2010 election cycle
      ** Third Report suffices for 2011 Annual Filing if candidate also filed Report Nos. 1 and 2
1. Total Monetary Contributions Received in Excess of $100
    (See page 1 of instruction sheet)
$ 18,325.00   $ 18,325.00
2. Total Monetary Contributions in the form of loans guaranteed by a third
    party.  (See page 1 of instruction sheet)
$ 0.00   $0.00
3. Total Monetary Contributions in the form of loans that were forgiven
    (See page 2 of instruction sheet)
$ 0.00   $0.00
4. Total Amount of Monetary Contributions Received
    (Add Lines 1 through 3)  (See page 2 of instruction sheet)
$ 18,325.00   $18,325.00
5. Total Amount of Written Commitments for Contributions
    (When commitment is funded, report as contribution (monetary or in kind))
    (See page 2 of instruction sheet)

$ 0.00   $0.00
6. Total Value of In Kind Contributions Received in
    Excess of $100   (See page 2 of instruction sheet)
$ 0.00   $0.00
 
7. Total Monetary Expenses Paid in Excess of $100
    (See page 2 of instruction sheet)
$ 13,677.89   $13,677.89
8. Total Value of In Kind Expenses in Excess
    of $100  (See page 2 of instruction sheet)
$ 823.74   $823.74
 
I Declare Under Penalty of Perjury That the Foregoing is True and Correct.

John Madole, Jr. 01/15/2010
Signature Date
 

 CAMPAIGN CONTRIBUTIONS Report Period   # An.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

Contributions in Excess of $100 or, When Added Together from One Contributor Exceeds $100
Transfer Total Amount of All Campaign Contributions to Line 1 of Contributions Summary


 CONTRIBUTOR'S NAME AND
ADDRESS
 DATE OF EACH
CONTRIBUTION
 AMOUNT OF EACH
CONTRIBUTION
 CHECK
HERE
IF LOAN
 NAME AND
ADDRESS OF
3rd PARTY IF
LOAN
GUARANTEED
BY 3rd PARTY
 NAME AND ADDRESS
OF PERSON WHO
FORGAVE THE LOAN,
IF DIFFERENT THAN
CONTRIBUTOR
St. Mary's Health Plans
1510 Meadow Wood Lane
Reno, NV 89502
07/01/2009$600.00   
Nevada Cement Company
P. O. Box 840
Fernley, NV 89408
07/01/2009$600.00   
Pavers Plus
9185 Mile Circle
Reno, NV 89502
07/01/2009$600.00   
Penhall Company
550 E. Parr
Reno, NV 89512
08/26/2009$600.00   
RHP MECHANICAL SYSTEMS
PO BOX 2957
RENO, NV 89505
08/26/2009$600.00   
Nevada Chapter AGC
P.O. Box 7578
Reno, NV 89510
12/31/2009$15,325.00   

This page may be copied or duplicated if additional space is needed.

 

 WRITTEN COMMITMENTS Report Period   # An.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

Written Commitments in Excess of $100 or, When Added Together from One Entity Exceeds $100
Transfer Total Amount of All Written Commitments to Line 5 of Contributions Summary


 NAME AND ADDRESS OF PERSON WHO
MADE THE COMMITMENT
 DATE OF EACH
COMMITMENT
 AMOUNT OF EACH
COMMITMENT
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

This page may be copied or duplicated if additional space is needed.

 

 CAMPAIGN EXPENSES Report Period   # An.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

Expense Categories

 CATEGORIES  CODE
 Office expenses A
 Expenses related to volunteers B
 Expenses related to travel C
 Expenses related to advertising D
 Expenses related to paid staff E
 Expenses related to consultants F
 Expenses related to polling G
 Expenses related to special events H
 ** Goods and services provided in kind for which money would otherwise
   have been paid
I
 Other miscellaneous expenses J










** NRS 294A.362 requires “In Kind” contributions and expenses to be reported on a separate form, which is attached.
 

 CAMPAIGN EXPENSES Report Period   # An.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

Expenses in Excess of $100
Transfer Total Amount of All Campaign Expenses to Line 7 of Expenses Summary


 NAME AND ADDRESS OF
 PERSON, GROUP OR
 ORGANIZATION WHO RECEIVED
 THE PAYMENT FOR THE
 EXPENSE(S)
CATEGORY
(See Previous Page)

NRS 294A.365
DATE OF EACH
EXPENSE
AMOUNT OF
EACH EXPENSE
Washoe County Registrar of Voters
1001 E. Ninth St.
Reno, NV 89512
G07/10/2009$2,427.89
Committee to Elect Ben Kieckhefer
10045 Goler Wash Ct
Reno, NV 89521
J07/20/2009$1,000.00
Committee to Elect Senator Dennis Nolan
407 Keystone Dr
Dayton, NV 89403
J09/02/2009$1,500.00
Senate Republican Leadership Conference
PO Box 281
Reno, NV 89504-0281
J09/30/2009$500.00
Republican Assembly Caucus
8625 W Sahara Ave
Las Vegas, NV 89117
J10/06/2009$1,000.00
John Breternitz for County Commissioner
P.O. Box 1036
Reno, NV 89510
J10/06/2009$500.00
Committee to Elect David Humke
3855 Vantage Way
Reno, NV 89502
J10/14/2009$500.00
Committee to Elect Dwight Dortch
3435 Socrates Dr.
Reno, NV 89512
J10/23/2009$500.00
Committee to Elect Sharon Zadra
PO Box 12865
Reno, NV 89512
J10/23/2009$500.00
Committee to Elect Bob Cashell
3945 Innsbruck Ct.
Reno, NV 89509
J10/23/2009$1,000.00
Committee to Elect Bonnie Weber
8580 Sopwith Blvd
Reno, NV 89506
J11/13/2009$500.00
Committee to elect Joe Hardy
833 Nevada Way
Boulder City, NV 89015
J12/09/2009$1,500.00
Committee to Elect Heidi Gansert
316 California Ave #302
Reno, NV 89509
J12/09/2009$1,250.00
Committee to Elect Tom Grady
43 Fairway Drive
Yerington, NV 89447-2170
J12/09/2009$1,000.00
 
This page may be copied or duplicated if additional space is needed.

 


 IN KIND CONTRIBUTIONS AND EXPENSES REPORT




IN KIND CONTRIBUTION IS DEFINED AS THE VALUE OF SERVICES PROVIDED IN KIND FOR WHICH MONEY WOULD HAVE OTHERWISE BEEN PAID.
In kind contributions and expenses include: paid polling and resulting data, paid direct mail, paid solicitation by telephone, any paid paraphernalia that was printed or otherwise produced to promote a campaign and the use of paid personnel to assist in a campaign. An in kind contribution may also include, but is not limited to: goods and services such as billboards, office space, printing, food and beverage and yard signs.

The donor of in kind contributions shall furnish to the recipient (candidate or other person), a written statement setting forth the actual cost of those services or the fair market value within 30 days after the time he furnishes those services. (NAC 294A.043)

Examples of in kind contributions: (1) A person contributes billboard space and does not charge the candidate. The candidate would report the fair market value or actual cost of the billboard space as an in kind contribution; (2) A person pays for the printing cost of political signs for a candidate. The candidate would report the actual cost or fair market value of printing the signs as an in kind contribution.

Example of in kind expenses: (1) A person contributes the use of a large room to a candidate as an in kind contribution. Once the candidate utilizes the room it becomes an in kind expense to be reported.
 

 IN KIND CAMPAIGN
CONTRIBUTIONS
Report Period   # An.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

IN KIND

Contributions in Excess of $100 or, When Added Together from One Contributor Exceeds $100
Transfer Total Value of All In-Kind Campaign Contributions to Line 6 of Contributions Summary


 CONTRIBUTOR'S
NAME AND
ADDRESS
 DATE OF
EACH
IN KIND
CONTRI-
BUTION
 DESCRIPTION OF
EACH
IN KIND
CONTRIBUTION
 VALUE OR COST
OF EACH
IN KIND
CONTRIBUTION/
COMMITMENT
 CHECK
HERE
IF
LOAN
 NAME AND
ADDRESS OF 3rd
PARTY IF LOAN
GUARANTEED
BY 3rd PARTY
 NAME AND
ADDRESS OF
PERSON WHO
FORGAVE THE
LOAN
       
       
       
       
       
       
       
       
       
       
       
       
       





This page may be copied or duplicated if additional space is needed.

 

 IN KIND
WRITTEN COMMITMENTS
Report Period   # An.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

In Kind Written Commitments in Excess of $100 or, When Added Together from One Entity Exceeds $100
Transfer Total Amount of All Written Commitments to Line 5 of Contributions Summary


 NAME AND ADDRESS OF PERSON WHO
MADE THE IN KIND COMMITMENT
 DATE OF EACH
IN KIND
COMMITMENT
 AMOUNT OF EACH
IN KIND
COMMITMENT
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

This page may be copied or duplicated if additional space is needed.

 

 IN KIND CAMPAIGN
EXPENSES
Report Period   # An.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

IN KIND

Expenses in Excess of $100
Transfer Total Value of All In-Kind Campaign Expenses to Line 8 of Expenses Summary


 NAME AND ADDRESS OF
 PERSON, GROUP OR
 ORGANIZATION WHO RECEIVED
 THE IN KIND GOOD(S) OR
 SERVICE(S)
DESCRIPTION
OF EACH
IN KIND
EXPENSE
DATE OF
EACH
IN KIND
EXPENSE
VALUE OR COST
OF EACH
IN KIND
EXPENSE
Committee to Elect Joe Heck
P.O. Box 70
Las Vegas, NV 89125
Food for Mixer07/20/2009$216.01
Committee to Elect Ben Kieckhefer
10045 Goler Wash Ct
Reno, NV 89521
2x3 Sign11/13/2009$53.86
Committee to Elect Ben Kieckhefer
10045 Goler Wash Ct
Reno, NV 89521
Political Buttons12/30/2009$220.84
Committee to Elect Brian Sandoval
4145 Latigo Drive
Reno, NV 89509
Luncheon12/30/2009$333.03

This page may be copied or duplicated if additional space is needed.

Prescribed by Secretary of State
NRS 294A.120, 294A.125,
294A.140, 294A.150, 294A.160
294A.200, 294A.210, 294A.220, 294A.362