SCHEDULE A CONTRIBUTIONS AND OTHER...
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KANSAS GOVERNMENTAL ETffiCS COMMISSION RECEIPTS AND EXPENDITURES REPORT R ECErvED OF A CANDIDATE FOR STATE OFFICE J AN 1 0 2017 January 10, 2017 KS Gcmrnmentai Etr1ics Commissilf FILE WITH SECRETARY OF STATE SEE REVERSE SIDE FOR INSTRUCTIONS A. Name of Candidate Sen. Laura Kelly Address 234 SW Greenwood Avenue City and Zip Code Topeka, KS 66606 County Shawnee Office Sought State Senator District No. 18 B. Check only if appropriate: D Amended Filing D Termination Report --- -- C. Summary (covering the period from 10/28/2016 through 12/31/2016 ) 1. Cash on hand at beginning of period $54,494.00 - 2. Total Contributions and Other Receipts (Use Schedule A) $13,295.00 --· , _ ___ ,,,, ____ ,_,,, __ ,_,,,., __ ,,., __ ,_---· ---··-- 3. Cash available this period (Add Lines 1 and 2) $67,789.00 4. Total Expenditures and Other Disbursements (Use Schedule C) $42,369.71 5. Cash on hand at close of period (Subtract Line 4 from 3) $25,419.29 -- -- 6. In-Kind Contributions (Use Schedule B) $0 .00 7. Other Transactions (Use Schedule D) $0 .00 D. "I declare that this report, including any accompanying schedules and statements, has been examined by me and to the best of my knowledge and belief is true, correct and complete. I understand that the intentional failure to file this document or intentionally filing a false document is a class A misdemeanor." ... ")..o '1 Date Signfmre of ori_reasurer f 1-M<..c... _ft.,.r · GEC Form Rev 2016 --nJ:- LL L • ·- 111 ., ... _.
Transcript of SCHEDULE A CONTRIBUTIONS AND OTHER...
KANSAS GOVERNMENTAL ETffiCS COMMISSION
RECEIPTS AND EXPENDITURES REPORT RECErvED OF A CANDIDATE FOR STATE OFFICE
JAN 1 0 2017 January 10, 2017 KS Gcmrnmentai Etr1ics Commissilf ~
FILE WITH SECRETARY OF STATE SEE REVERSE SIDE FOR INSTRUCTIONS
A. Name of Candidate Sen. Laura Kelly
Address 234 SW Greenwood Avenue City and Zip Code Topeka, KS 66606 County Shawnee
Office Sought State Senator District No. 18
B. Check only if appropriate: D Amended Filing D Termination Report --- --
C. Summary (covering the period from 10/28/2016 through 12/31/2016 )
1. Cash on hand at beginning of period $54,494.00 -2. Total Contributions and Other Receipts (Use Schedule A) $13,295.00
--· , ____ ,,,, ____ ,_,,, __ ,_,,,., __ ,,., __ ,_---·---··--
3. Cash available this period (Add Lines 1 and 2) $67,789.00
4. Total Expenditures and Other Disbursements (Use Schedule C) $42,369.71
5. Cash on hand at close of period (Subtract Line 4 from 3) $25,419.29 -- --6. In-Kind Contributions (Use Schedule B) $0.00
7. Other Transactions (Use Schedule D) $0.00
D. "I declare that this report, including any accompanying schedules and statements, has been examined by me and to the best of my knowledge and belief is true, correct and complete. I understand that the intentional failure to file this document or intentionally filing a false document is a class A misdemeanor."
lO-~ ... ")..o '1 fr~l~ Date Signfmre of Can~ate ori_reasurer f 1-M<..c... o~ _ft.,.r · GEC Form Rev 2016
--nJ:- LL L • ·- ~ 111 ., ... _. r-"-~
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
David C. Ade 1033 SW Billard Ave
11/04/2016 Topeka, KS 66604-1620 D D D
Allstate Insurance Company 2775 Sanders Rd
11/03/2016 Northbrook, IL 60062-6110 D [Z] D
ARJ Infusion Services, Inc. 10049 Lakeview Ave
11/03/2016 Lenexa, KS 66219-2501 D [Z] D
Marilynn L. Ault 1506 SW Boswell Ave
11/01 /2016 Topeka, KS 66604-2723 D D D
Linda Baker 4917 SW Cedar Crest Rd
10/28/2016 Topeka, KS 66606-2217 D [Z] D
Larry Bakerink 4016 W 26th Ter
11/02/2016 Lawrence, KS 66047-2661 D D D
BCS Design, Inc. 19930 W 161st St
10/28/2016 Olathe, KS 66062-2700 D [Z] D
Amount of Cash, Check,
Loan or E funds Other Other Receipt
[Z] $25.00
D $200.00
D $1,000.00
[Z] $50.00
D $50.00
[Z] $25.00
D $500.00
$1,850.00
Page 2 of 10
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
David Blakely MD 6019 SW 36th Ct
11/01/2016 Topeka, KS 66614-5124 D D D
Patricia B. Booth 625 SW Crest Dr
11/02/2016 Topeka, KS 66606-2303 D D D
Michele "Shelly" A Buhler 434 Spruce St
11/03/2016 Rossville, KS 66533-9759 D 0 D
Caremark Rx Inc. PO Box 287
11/16/2016 Lincoln, RI 02865-0393 D 0 D
Charles Dedmon 24125 Bunny Trail Rd
11/02/2016 Alma, KS 66401-8840 D D D
Duane Dunn 4318 Wamteau Dr
11/03/2016 Wamego, KS 66547-9378 D D D
Sue McCoy Edwards 407 SW Woodlawn Ave Registered Nurse
11/05/2016 Topeka, KS 66606-1246 D D D Health Care
Amount of Cash, Check,
Loan or E funds Other Other Receipt
0 $50.00
0 $25.00
D $50.00
D $250.00
0 $25.00
0 $100.00
0 $200.00
$700.00
Page 3 of 10
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
Kim Engelman 9403 W 150th St
11/02/2016 Overland Park, KS 66221-2512 D D D
Express Scripts Inc. 1 Express Way
11/03/2016 Saint Louis, MO 63121-1824 D 0 D
General Motors Company 25 Massachusetts Ave NW
11/03/2016 Ste 400 D 0 D Washington, DC 20001-1427
Elizabeth R. Herbert 1328 SW Plass Ave
11/02/2016 Topeka, KS 66604-2748 D D D
Kathy Holmes 506 SW Garfield Ave
11/02/2016 Topeka, KS 66606-1656 D D D
Craig Hulse 15 Count Fleet Ct
11/01/2016 Reno, NV 89502-9767 D D D
Humane Society Legislative Fund- Kansas PAC
11/02/2016 11460 Tomahawk Creek Pkwy D 0 D Ste 300 Leawood, KS 66211-7819
Amount of Cash, Check,
Loan or E funds Other Other Receipt
0 $50.00
D $100.00
D $250.00
0 $50.00
0 $25.00
0 $50.00
D $500.00
$1,025.00
Page 4 of IO
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
Terry Humphrey 1321 SW Lakeside Dr
11/01/2016 Topeka, KS 66604-2581 0 0 0
William Jones PO Box 1015 Entrepreneur
11/16/2016 Cleveland, TN 37364-1015 0 0 0 Financial
Donald A. Jordan 34505 Woodland Rd
11/02/2016 Paola, KS 66071-6207 0 0 0
Kansas Pharmacists Association PAC
11/03/2016 1020 SW Fairlawn Rd 0 0 0 Topeka, KS 66604-6055
Kansas Society of Anesthesiologists
12/28/2016 3901 Rainbow Blvd 0 0 0 Ms 1034 Kansas City, KS 66160-8500
Kansas Society of CPA's PAC 100 SE 9th St
12/28/2016 Ste 502 0 0 D Topeka, KS 66612-1213
Laura J. Kelly 234 SW Greenwood Avenue Senator
12/31/2016 Topeka, KS 66606 0 D D . Government
Amount of Cash, Check,
Loan or E funds Other Other Receipt
0 $100.00
0 $600.00
0 $50.00
D $500.00
0 $1,000.00
0 $250.00
0 $3,160.00
$5,660.00
Page 5 of 10
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
Francis Kelsey PO Box 127
11/01/2016 Silver Lake, KS 66539-0127 D D D
Leadingage Kansas 217 SE 8th Ave
11/03/2016 Topeka, KS 66603-3906 D [Z] D
Loan Max 1605 E Santa Fe St
11/03/2016 Olathe, KS 66061-3644 D [Z] D
Roy Menninger 85 SW Pepper Tree Ln
11/02/2016 Topeka, KS 66611-2072 D D D
Richard Meyer 3320 NW 42nd Ter
11/02/2016 . Topeka, KS 66618-2629 D D D
Kathryn Moore 2720 Brittany Ter
11/01/2016 Manhattan, KS 66502-27 41 D D D
Mariangeles Murphy-Herd 1530 NE 31st St
11/02/2016 Topeka, KS 66617-3554 D D D
Amount of Cash, Check,
Loan or E funds Other Other Receipt
[Z] $50.00
D $250.00
D $250.00
[Z] $50.00
[Z] $25.00
[Z] $25.00
[Z] $10.00
$660.00
Page 6 of 10
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
Cynthia Nadeau 5330 NE Kincaid Rd '
10/31/2016 Topeka, KS 66617-4030 D D D
NEA Topeka PAC 715 SW 10th Ave
10/28/2016 Topeka, KS 66612-1617 D 0 D
Prairie Band Potawatomi Nation
10/28/2016 16281 Q Rd D 0 D Mayetta, KS 66509-8970
Property Casualty Insurers Assoc PAC
11/03/2016 8700 W Bryn Mawr Ave D 0 D Chicago, IL 60631-3507
QC Holdings Inc. 9401 Indian Creek Pkwy
\
10/28/2016 Ste 1500 D 0 D Overland Park, KS 66210-2020
David Rodeheffer 2813 SW Burlingame Rd
11/01/2016 Topeka, KS 66611-1381 D D D
Larry Rodehorst 3629 NE Applewood Dr
11/02/2016 Topeka, KS 66617-3712 D D D
Amount of Cash, Check,
Loan or E funds Other Other Receipt
0 $50.00
D $50.00
D $500.00
D $100.00
D $600.00
0 $25.00
0 $50.00
$1,375.00
Page 7 of 10
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
Joseph Sessel 5024 SW Brentwood Rd
11/02/2016 Topeka, KS 66606-2210 D D D
Mary Reed Spencer 370 Lakeshore Dr
11 /01 /2016 Alma, KS 66401-9760 D 0 D
Spirit Aerosystems PO Box 780008
10/28/2016 Wichita, KS 67278-0008 D 0 D
Teva Pharmaceuticals 1090 Horsham Rd
11/08/2016 North Wales, PA 19454-1505 D 0 D
Truity Credit Union PO Box 1358
11/03/2016 Bartlesville, OK 7 4005-1358 D 0 D
Sharon Warman 723 SW Clay St
11/01/2016 Topeka, KS 66606-1433 D D D
Barbara Waterman-Peters 2223 SW Knollwood Dr
11/02/2016 Topeka, KS 66611-1623 D D D
Amount of Cash, Check,
Loan or E funds Other Other Receipt
0 $100.00
D $50.00
D $1 ,000.00
D $250.00
D $200.00
0 $10.00
0 $50.00
$1,660.00
Page 8 of 10
Sen. Laura Kelly
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
(Name of Candidate, Party Committee or Political Committee)
Check Occupation & Industry of Appropriate Box
Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan
Sheldon Weisgrau 444 Ohio St
11/01/2016 Lawrence, KS 66044-1373 D D D
Dodie Wellshear 3600 SW Randolph Sq Government Relations
11/03/2016 Unit 3 Consultant D D D Topeka, KS 66611-3008 Lobbying
Darlene Whitlock 415 Aquarius St
11/01/2016 Silver Lake, KS 66539-9605 D D D
June Windscheffel PO Box 5049
11/02/2016 Topeka, KS 66605-0049 D D D
Nikaela Zimmerman 5743 Cmr467
11/06/2016 Apo, AE 09096-0058 D D D
Complete if this is the last page of Schedule A
Total Itemized Receipts for Period
Total Unitemized Contributions
Sale of Political Materials (Unitemized)
Total Contributions When Contributor Not Known
Amount of Cash, Check,
Loan or E funds Other Other Receipt
lZI $25.00
0 $250.00
lZI $20.00
lZI $50.00
lZI $20.00
$13,295.00
$0.00
$0.00
$0.00
$13,295.00
$365.00
Page 9 of 10
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Sen. Laura Kelly (Name of Candidate, Party Committee or Political Committee)
Date Name and Address Purpose of Expenditure or Disbursement Amount
11/30/2016 Kansas Democratic Party Salaries for Campaign Staff Members - $1,625.99 PO Box 1914 Miscellaneous Topeka, KS 66601-1914
11/01/2016 Kaw Valley Bank Bank Card Service Fees - Miscellaneous $20.49 1110 N Kansas Ave Topeka, KS 66608-1244
12/01 /2016 Kaw Valley Bank Bank Card Service Fees - Miscellaneous $81.42 1110 N Kansas Ave Topeka, KS 66608-1244
11/14/2016 Laura J. Kelly Candidate reimbursement- variety of $12,187.31 234 SW Greenwood Avenue expenses - Reimbursement Topeka, KS 66606
10/28/2016 Mad Dog Mail, Inc. Campaign Mailing- Production & Postage - $6,676.50 5542 First Coast Hwy Printing Ste 300 Fernandina Beac, FL 32034-5088
10/28/2016 Mary Christine & Associates TV & Radio Buys - Radio/TV $21,218.00 PO Box 1574 Lawrence, KS 66044-857 4
11/14/2016 Wabaunsee County Signal-Enterprise Print Advertising - Newspaper Ads $560.00 PO Box 158 Alma, KS 66401-0158
Complete if last paee of Schedule C Total Itemized Expenditures This Period $42,369.71
Total Unitemized Expenditures $50 or less $0.00
TOTAL EXPENDITURES & OTHER DISBURSEMENTS $42,369.71
THIS PERIOD (to line 4 of Summary)
: ._I ___ $_4_2_.3-69_._11__, Subtotal This Pag~
.... ' ~- ~-~--~"--~~---~--~--~
Page _lQ_ of _lQ_
LAURA KELLY SENATE CAMPAIGN 2016 General Campaign- Laura Kelly Reimbursable Expenses Detailed support for check no. 1028 dated November 14, 2016
Date Vendor
10/18/2016 Best Buy
10/26/2016 Community Health Ministries
10/12/2016 DriveSaver
10/25/2016 Emporia Gazette
9/15/2016 HyVee
11/8/2016 Office Max
11/8/2016 Office Max
10/31/2016 Office Max
10/18/2016 Pottawatomie County Clerk
10/18/2016 Sam's Club
10/7/2016 Shawnee County Elections
3/18/2016 Stanley's Flowers
9/16/2016 Stanley's Flowers
10/19/2016 Stanley's Flowers
10/10/2016 Topeka Capital -Journal
10/6/2016 Topeka Capital-Journal
10/31/2016 USPS
11/7/2016 Walmart
KELLY FOR SENATE 234 SW GREENWOOD A VE TOPEKA, KS 66606-1228
Description of Expense
Computer
Donation
Data Recovery
Wamego SS ads
Fund Raiser Catering
Party Poster
Party Poster
Labels
AdVotelist
Fund Raiser Catering
AdVotelist
Flowers for Fundraising Host
Flowers for Fund raising Host
Flowers for Fundraising Host
Digital Ads
Print Ads
Postage Stamps
Tickets
44-14/1011
Amount
$ 927.76 100.00
.3,560.00 292.50 504.16
22.09
7.96 42.81 16.70 73.83
125.00 65.49 65.49 65.49
3,160.00
3,100.00
51.00 7.03
$ 12,187.31
1028
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