Form No. DEC-2015 ETHICS COMMISSEON FINANCIAL DISCLOSURE STATEMENT This statement is to be filed in 2016 Piease type or print cleariy. See instructions for assistance with this page. Financial information for calendar year 2015 A. PERSONAL CONTACT INFORMATION Last Name First Name Randazzo Samuel B. STATUS (Check all that apply) Candidate CANDIDATES: Please list the date of Write-in Candidate the first election (primary, speciai, or Elected to an office general) when your name will appear Appointed to an unexpired on the ballot. term in elective office Pubiic Official Month Day Year Pubiic Employee 2016 Voluntary Filer FOR OFFICIAL USE ONLY Online 4/5/2016 i:16 PM Confirm 1304164716051 C. PUBLIC POSITION, OFFICE, OR JOB Position/Titie (Example: council member, sheriff, board member, orjob titie) Seeking Board Member Held Public Entity you serve in 2016, served in 2015, or wili serve if elected Public Utilities Commission of Ohio Nominating Committee Public Salary: Start Date: End Date: Uncompensated Month Day Year Month Day Year Less than $16,000 516,000 or more i D. PUBLIC POSITION, OR JOB Position/Titie (Example: council member, sheriff, board member, orjob titie) Seeking Hoid Held Public Entity you serve in 2016, served in 2013, or wili serve if elected Public Salary: Start Date: End Date: Uncompensated Month Day Year Month Day Year Less than $16,000 516,000 or more FOR ETHICS USE ONLY Walkmin Filer has answered every required question. Inter Office Filer has not answered these questions: No Check Rev'd by: Date incomplete form returned to filer: Date completed form returned to OEC: Page 1 of 4 I. SOURCES OF INCOME - ALL MUST ANSWER THIS QUESTEON: I have no sources of income that i am required to list. (For help, see instructions page Source of Income Service Provided ($3333.22) A McNees Waliace Nurick LLC legal services/management Administration Company management Sustainability Funding Alliance of Ohio management Chase Bank] Huntington interest Check instructiens to see whether you are required to disclose amounts of income. 2. SOURCES OF GEFTS - ALL FILERS MUST ANSWER Ti-iiS QUESTION: I have no sources of gifts that I am required to iist. (For help, see instructions page 5) Source of Gift Source of Gift A 3. NAMES OF SPOUSE IN HOUSEHOLD AND ANY DEPENDENT CHILDREN - ALL MUST ANSWER rHis QUESTION: There are no immediate family members whose names I am required to list. Spouse Residing in Household Carol D. Farmer Dependent Chiidren 4. NAMES 0F BUSENESSES - ALI. ANSWER Ti'liS (For help, see instructions page Dependent Children (For help, see instructions page E) if you or anyone you listed in Question 3 owns or operates a business, Eist the name of the business. There are no business names that I am required to list. Business Name Business Name A McNees Waliace Nurick Sustainability Funding Alliance of Ohio Administration Company 5. LAND (REAL ESTATE) iN - MUST ANSWER rHis QUESTION: (For help, see instructions page a) have no real estate that I am required to list. Land (Real Estate) in Ohio (List address or, if address is unavailabie, plat number and county) A 1725 Gerrard Avenue, Coiurnbus, OH 43212 1788 W. Third, Columbus, OH 43212 1101 Broadview Avenue, Columbus. 03-! 43212 You are not required to disclose your personal residence or real property held primarily for personal recreation. Page 2 of 4 6. CREDITORS OVER $1,000 - ALL MUST ANSWER THIS QUESTION: (For help, see instructions range I have no creditors that i arn required to list. Creditor Creditor A 7. DEBTORS OVER 51,000 - ALE. MUST ANSWER THIS QUESTION: (For help, see instructions tinge 53) I have no debtors that I am required to iist. Debtor Debtor A 8. ENVESTMENTS OVER 51,000 - ALL Frtens MUST ANSWER THIS QUESTION: (For help, see instructions page and T) I have no investments that I am required to list. Corporation, Trust, Business Trust, Partnership, or Association Nature of Investment A McNees Waliaoe Nuriok LLC Equity member?law firrn iEU-Ohio Administration Company Owner Sustainability Funding Alliance of Ohio Owner E. iF YOU NEED ADDITIONAL SPACE, PLEASE ATTACH A SEPARATE SHEET. 9. FIDUCIARY RELATEONSHIPS - Ari. MUST ANSWER QUESTION: (For help, see instructions gage 8) I have no offices or fiduciary relationships that I am required to list. Corporation, Trust, Business Trust, Partnership, or Association Office or Nature of Relationship A industrial Energy Users-Ohio Generai Counsel SKIP QUESTIONS 10 AND 11 IF YOU ARE ONLY REQUIRED TO FILE AS A: - Coliege or university trustee 0 Candidate for a city, township, school district, or ESC - City, township, school district, ESC, or sanitary district official or employee serving in a position that is paid position that is paid Eess than $16,000 a year iess than $16,000 a year 10 . FOOD 0R BEVERAGES - ALL FILERS EXCEPT THOSE LISTED iN THE BOX ABOVE MUST ANSWER THIS QUESTION: I have no sources of meals, food, or beverages that I am required to iist. (For help, see instructions page 8) Source of Food or Beverages Source of Food or Beverages Page 3 of 4 11. TRAVEL EXPENSES - ALL FILERS EXCEPT 1N THE BOX ON PAGE 3 MUST ANSWER THis QUESTION: I have no sources of travel expenses that i am required to list. (For help, see instructions page 9) Source of Travei Expenses Amount A 12. NON-DISPUTED INFORMATION - ALL state employees, state officials and state board and commission members (except coiiege and university trustees) are REQUIRED to answer Question 12. Ali other filers should skip this question and go to question 13. have no information that I am required to list. (For help, see instructions huge a) Non-Disputed information 13. SIGNATURE - ALL MUSTSIGN TtiE (For help, see instructions huge 10) By signing this statement: . i swear or affirm that this statement and any additionai attachments have been prepared or carefully reviewed by me, and constitute my complete, truthfui, and correct disclosure of required information, and that the address iisted on page 1 is a correct mailing address. 0 i acknowledge and understand that, among other potential violations and penalties, knowingly filing a false statement is a criminal misdemeanor of the first degree, in violation of Sections 3.0202(0) and of the Revised Code, punishable by a fine of not more than $1,000, imprisonment of not more than six months, or both. - i acknowledge and understand that filing a false statement may be grounds for removal from pubiic office or dismissal from pubiic employment pursuant to Sections 3.04 and 124.34 of the Revised Code. 0 i acknowledge that, in 2015, I served in, or in 2016, I am serving in or a candidate for, the position indicated on page 1 of this statement. If you have any questions before signing this form, piease contact the Ohio Ethics Commission at (614) 466-7090. Before signing this statement, piease review to make sure that you have answered each question you are required to answer. if you have nothing to iist in response to any question, check the box indicating that you have nothing to list. If the response to any required question is omitted, the Commission will return the statement to you as incompiete. Any person who fails to fiie a complete statement by the appropriate filing deadiine wiil be assessed a late filing fee and may be subject to criminal penalty. Deliver compieted statement to: Ohio Ethics Commission, 30 W. Spring St., L3, Columbus, OH 43215 My filing fee is: (For help, see instructions nage 2) Enciosed (checi< or money order payable to "Ohio Ethics Commission") Submitted Oniine Included in my attorney registration fees (Judges, Magistrates, and Judiciai Candidates Only) My pubiic agency is required or has agreed to pay my filing fee. YOUR IS HERE: SW 0. Date: 4/5/2016 1:16 PM Confirmation Number: 1304164716051 Rev'd 14,35 Page 4 of 4