Los Angeles County Registrar-Recorder County Clerk

Dean C. Logan
Registrar-Recorder/County Clerk

Department Headquarters
12400 Imperial Highway
Norwalk, California 90650

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Schedule G Payments Made by an Agent or Independent Contractor	CALIFORNIA FORM 460

NAME OF FILER
MOLINA OFFICEHOLDER ACCOUNT

I.D. NUMBER
962879

Schedule G Detail (9 Records)

Payee, Creditor, or Recipient and Agent	Expenditure Code (?)	Description of Payment	Amount Paid
NAME OF AGENT OR INDEPENDENT CONTRACTOR US BANK
BJ PARTY SUPPLIES	OFC	SUPPLY RENTAL STAFF HOLIDAY PARTY (STAFF LIST ATTACHED	$300.96
EL GALLO GRILL	MTG	FOOD FOR STAFF LUNCHEON (STAFF LIST ATTACHED	$130.00
MIJARES MEXICAN RESTAURANT	OFC	SUPPLIES FOR STAFF HOLIDAY PARTY (STAFF LIST ATTACHED)	$231.28
SMART AND FINAL	OFC	SUPPLIES FOR STAFF HOLIDAY PARTY (STAFF LIST ATTAHCED)	$114.20
STARBUCKS CORP.	OFC	SUPPLIES FOR STAFF HOLIDAY PARTY (STAFF LIST ATTACHED	$275.00
TARGET	OFC	GIFTS AND SUPPLIES FOR STAFF HOLIDAY PARTY (STAFF LIST ATTACHED)	$432.25
US AIRWAYS4	OFC	AIR FARE FOR STAFFMEMBER AVIANNA URIBE TO ATTEND COUNTY RELATED FUNERAL	$349.60
US POSTAL SERVICE	POS	POSTAGE FOR HOLIDAY CARDS	$1,452.00
VONS	OFC	SUPPLIES FOR STAFF HOLIDAY PARTY (SATFF LIST ATTACHED)	$436.60
TOTAL			$3,721.89