KANSAS GOVERNMENTAL ETHICS COMMISSION
ECEIPTS AND EXPENDITURES REPORT A POLITICAL OR PARTY COMMITTEE \ October 27, 2008 ILE WITH SECRETARY OF STATE REVERSE SIDE FOR INSTRUCTIONS
A. Name of Committee: Kansas Insurance Agents Political Action Committee
Address: 815 SW Topeka Blvd
City and Zip Code: Topeka 66612 ------This is a (check one): __ Party Committee '" Political Committee
B. Check only if appropriate: __ Amended Filing __ Tennination Report
C. Summary (covering the period from July 25, 2008 through October 23, 2008)
1. Cash on hand at begiIU1ing of period . 35494.77
2. Total Contributions and Other Receipts (Use Schedule A) . 25120.20
3. Cash available this period (Add Lines I and 2) . 60614.97 4. Total Expenditures and Other Disbursements (Use Schedule C) . 38276.16 5. Cash on hand at close of period (Subtract Line 4 from 3) .. 22338.81 6. In-Kind Contributions (Use Schedule B) ...... o 7. Other Transactions (Use Schedule D) .. o
10/23/08 Date
GEe Form Rev, 2001 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Cbeck Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Tban $150 Loan or Cash Check Loan Other Other Receipt
1st Choice Insurance Agency 8/12/08 105 W Main .f $75.00 Norton,KS 67654
1st Choice Insurance, LLC 9/5/08 118 W Greeley Ave .f $75.00 Tribune, KS 67879
AASI Insurance, Inc. 9/10/08 2820 SE 29th .f $75.00 Topeka, KS 66605-2263
ABK Insurance Agency, Inc. Insurance 9/5/08 3339 SE Adams St. .f $225.00 Topeka, KS 66605
Accident Fund Ins Co. of America 8/25/08 232 S Captiol Ave .f $75.00 Lansing, MI 48933
Acuity 8/20/08 1202 Old Hawthorne Drive E .f $75.00 Columbia, MO 65201
Agency, Inc, The 8/20/08 122 N Main $75.00 Lakin, KS 67860 v'
Agency in Montezuma, Inc., The 8/12/08 101 Zaldivar $75.00 Montezuma, KS 67867 .f
Agency Services Corp of Kansas 9/30/08 815 S Topeka Blvd .f $75.00 Topeka, KS 66612
Agri-Risks Services, Inc. 9/10/08 7540 W 160th St. $75.00 Stillwell, KS 66085 .f
AIG Speciality Auto 10/17/08 1310 Morris Road, Ste 600 .f $75.00 Alpharetta, GA 30004 _. - . $975.00 SubtotalThis Page "'"'
Page _1_ ofKl_ SCHEDULE A CONTRIBUTIONS Al\'D OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name ofPany Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 LoaD or Cash Check Loall Olbe, Other Receipt
Air Capital Insurance, LLC 9/3/08 125 East 2nd St. ~ $75.00 Wichita, KS 67202
All Insurance Access, LLC 8/14/08 3706 SW Topeka Blvd, Ste 411 .; $75.00 Topeka, KS 66609
Allied Ins.-A Mbr of Nationwide Ins 8/20/08 PO Box 80758 ~ $75.00 Lincoln, NE 68501
Almena State Bank 8/6/08 500 Main ~ $75.00 ' Almena, KS 67622-0127
AOPA Insurance Agency, Inc. 8/14/08 1995 Midfield Rd ~ $75.00 Wichita, KS 67209
Applied Systems, Inc. 10/17/08 200 Applied Parkway ~ $75.00 University Park, IL 60456
ARMtech Insurance Services 9/10/08 1310 S Sherman Ave .; $75.00 Liberal, KS 67901
AutoSure, Inc. 8/6/08 900 S Second ~ $75.00 Dodge City, KS 67801
Avery Agency, W.E. 8/14/08 201 N Walnut. ~ $75.00 Peabody, KS 66866-0131
Ayres Insurance Agency, LLC 8/6/08 201 Starr Ave ~ $75.00 Miltonvale, KS 67486
Backman-Bishop Agency 8/6/08 2632 Tumbleweed Road ~ $75.00 Vermillion, KS 68544
$825.00 Subtotal Th,is Page
Page __~ ofZ-L SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Casb Check Loan Other Other Receipt
Baldwin Insurance Services 8/6/08 802 Ames Street ..; $75.00 Baldwin City, KS
Banco Insurance Agency 8/20/08 201 N Main ..; $75.00 Haviland, KS 67059
Berkley & Berkley Agency 9/3/08 104 S Main ..; $75.00 Tescott, KS 67484
Berkshire Hathaway 9/3/08 9290 W Dodge Rd ..; $75.00 Omaha, NE 68114
Beverly Insurance Agency 8/6/08 101 S Main ..; $75.00 Beverly, KS 67423
Billiups, Snyder & Associates 8/6/08 905Walnut ..; $75.00 Blue Springs, MO 64015
Braden Insurance & Real Estate 9/5/08 105 W 3rd St. $75.00 Eureka, KS 67045-1444 ..;
Brethren Mutual Aid Agency 8/20/08 3094 Jeep Road ..; $75.00 Abilene, KS 67410
Bridges Group, Inc. 9/5/08 117 N Kansas ..; $75.00 Norton, KS 67654-2050
Brooke Agency Services Co, LLC 8/14/08 103 W Parallel ..; $75.00 Clifton, KS 66937
Brooke Agency Services Co, LLC 8/6/08 104 N Douglas Ave ..; $75.00 Ellsworth, KS 67439
$825.00
Subtotal This l'·ag·e . " -~-
Paoe'" ---3 of2-1-- SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Ca~h Check Loan Olher Other Receipt
Brooke Agency Services CO,LLC 8/14/08 412 W Commercial ~ $75.00 Fairview, KS 66425
Brooke Agency Services Co, LLC 8/6/08 124 N Kansas ~ $75.00 Frankfort, KS 66427
Brooke Agency Services Co, LLC 8/6/08 610 Oregon ~ $75.00 Hiawatha, KS 66434
Brooke Agency Services Co, LLC 9/19/08 600 S Main St. ~ $75.00 Hugoton, KS 67951
Brooke Agency Services Co, LLC 8/14/08 PO Box 250 ~ $75.00 Maple Hill, KS 66507-0250
Brooke Agency Services Co, LLC 8/27/08 119B S Pennsylvania ~ $75.00 Ness City, KS 67560-0547
Brooke Agency Services Co, LLC 8/6/08 133 S Main $75.00 Smith Center, KS 66967 .f
Brown Insurance 8/27/08 105 N 8th ~ $143.75 Hiawatha, KS 66434
Bohrer, Croxdale & McAdoo, Inc. 8/20/08 601 SAve ~ $75.00 Springfield, MO 65801
Bolinger Agency 8/25/08 120 N Main ~ $75.00 Bucklin, KS 67834
Bolz Insurance, Inc. 9/5/08 PO Box 486 ~ $75.00 Lyndon, KS 66451-0486 .
~ $893.75 Subtotal TillIs Pa.g!f , .~~ 'Z
Page _4_ of2d SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Pan)' Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Cbeck Loan Otber Other Receipt
Builders' Ins Consultants, Inc. 8/14/08 1100 Walnut, Ste 3010 .; $75.00 Kansas City, MO 64106
Cananwill Premium Funding 10/17/08 8331 Oakview Circle .; $75.00 Lenexa, KS 66215
Capitol Agency 8/6/08 9500 Nail Ave, #305 .; $75.00 Overland Park, KS 66207
Capital Resources, LLC 9/3/08 7960 W 135th St. .; $75.00 Overland Park, KS 66223 "
Cardinal Insurance Co., Inc, 9/19/08 332 W 7th .; $75.00 Junction City, KS 66441
Carpenter & Co. 8/6/08 8301 State Line Rd, Ste G-A .; $75.00 Kansas City, MO 64114
Case & Son Insurance, Inc. 8/12/08 220 E Main $75.00 Marion, KS 66861-0217 .;
Central Insurance Agency Insurance 8/14/08 101SMiliSt. .; $375.00 Glen Elder, KS 67446-0008
Century 21 Miller & Midyett 9/5/08 1045 E 23rd St. .; $75.00 Lawrence, KS 66046
Charlson-Wilson Ins Agency 8/12/08 55 Poyntz Ave, Ste 205 .; $75.00 Manhattan, KS 66502-0023
Chris-Leef General Agency, Inc. 8/12/08 11503 W 75th St. .; $75.00 Shawnee, KS 66203-0747 .. .~. $1,125.00 ·Sub-total This Page ""
Page _~_ ofE SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Cbeck Loan Otber Other Receipt
Christian & Associates, Inc. 8/6/08 One Ward Parkway, Ste 106 .; $75.00 Kansas City, MO 64112
Citizens Insurance Agency 8/6/08 124 E Commercial .; $75.00 Waterville, KS 66548
Cline-Wood Agency, Inc. 8/27/08 11250 Tomahawk Creek Pkwy .; $75.00 Leawood, KS 66211
Cockrum Insurance Agency 8/6/08 202 S Main .; $75.00 Johnson, KS 67855-0130
Colonial Life 8/27/08 6710 W 121st St. .; $75.00 Overland Park, KS 66209
Commercial Risk Management 8/14/08 4121 W 83rd St., Ste 156 .; $75.00 Prairie Village, KS 66208-5323
Commercial Ins Associates, Inc. 8/27/08 6155 Oak St., Ste B .; $75.00 Kansas City, MO 64113
Commercial Ins Group, Inc. 8/6/08 400 N Woodlawn, Ste 100 .; $75.00 Wichita, KS 67208
Commercial Ins Underwriters Inc. 8/12/08 305 W Walnut Lawn .; $75.00 Springfield, MO 65808-9005
Community Ins Service, Inc. 8/25/08 309 Maple .; $75.00 Overbrook, KS 66524
Concannon Co., Inc. Michael F. 8/20/08 930 Kehrs Mill Road, #319 .; $75.00 Ballwin, MO 63022
$825.00 Subtotal This Page -'
Paae 6 of2--'7 '" --- -- SCHEDULE A CONTRIBUTIONS A.l\:"'D OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Narne of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cast! Cbeck Loa.n Otber Other Receipt
Conrad Insurance Agency 8/12/08 10701 Barkley St. $75.00 Overland Park, KS 66211 v'
Conrade Ins Group, Inc. 8/6/08 129 E Broadway, Ste 200 v' $75.00 Newton, KS 67114-0547
Convergent Insurance LLC 8/14/08 4980 Roe BlVd, Ste B. v' $75.00 Roeland Park, KS 66205
Corns & Ballard Agency 8/27/08 240 S Main $75.00 Greensburg, KS 67054-0787 v'
Corporate Assurance, Inc. 9/30/08 PO Box 3340 v' $75.00 Shawnee Mission, KS 66203
Corporate Insurance Group, Inc. 8/14/08 15357 Carter $75.00 Overland Park, KS 66221 v'
Coryell Insurors, Inc. 9/9/08 120 W 7th St. $100.00 Junction City, KS 66441 v'
Coup-Emig Ins Agency, LLC 8/6/08 112 N Main $75.00 Hope, KS 67451 v'
Cowell Insurance Group, Inc. 9/3/08 7501 NW Tiffany Springs Pkwy $75.00 Kansas City, MO 64153-1386 v'
Cretcher Heartland, Inc. 10/17/08 4551 W 107th St, 3rd Floor $75.00 Overland Park, KS 66207 v'
Cropland Insurance Agency, Inc. 8/6/08 114 W Main v' $75.00 Anthony, KS 67003
I~ $850.00 Sllbtota.J This Page -'
Paaeb 7 of .2-1_ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee eN arne of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Casb Check Loan Otber Other Receipt
Cushing Insurance Agency 8/6/08 800 N Morgan $75.00 Downs, KS 67437 DMS Agency, Inc. '" 8/6/08 105 S 6th St. $75.00 Hiawatha, KS 66434 Davidson Agency, The '" 8/6/08 124 W 2nd .( $75.00 Delphos, KS 67436
DeSoto Insurance Agency 8/6/08 33050 W 83rd $75.00 DeSoto, KS 66018 Dittmann Ins Agency, Bob '" 10/17/08 121 W 5th St. $75.00 Pittsburg, KS 66762 Dunn Agency, Inc. R E. (The) '" 9/10/08 2909 SW Maupin Lane $75.00 Topeka, KS 66614 Eberle Insurance Agency '" 8/6/08 272 Main .( $75.00 Grainfield, KS 67737
Eck Agency, Inc. 8/6/08 123 N Main $75.00 Attica, KS 67009
Eklund Insurance, LLC 8/6/08 1617 Clark '" $75.00 Goodland, KS 67735 Ellco Insurance Services '" 8/27/08 233 S Main $100.00 Lorraine, KS 67459 Elliott Insurance Group '" 8/6/08 278 Fairlane Dr. $75.00 Louisburg, KS 66053-0639
'" . $850.00 Th~is~~age I~ Subtotal . _.~ v .. , .... -
Paoeo 8 of z.,1_ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name ofPany Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Casb Cbeck Loan Other Other Receipt
Elliott Insurance Agency, Inc. 8/6/08 207 N Main, Ste 103 t/' $75.00 McPherson, KS 67460-0326
Emergency Servo Ins. Program 9/3/08 PO Box 5670 t/' $75.00 Courtland, NY 13045
Evans Real Estate Co., Inc 9/10/08 502 E 4th t/' $75.00 Tonganoxie, KS 66086-0224
Farm Credit Services-Central KS 8/20/08 7940 W Kellogg Drive t/' $75.00 Wichita, KS 67277
Farmers Alliance Ins Company 9/19/08 1122 N Main t/' $75.00 McPherson, KS 67460
Farmers Crop Insurance, LLC 8/20/08 651 NW Trafficway t/' $75.00 Rossville, KS 66533
Farmers & Merchants Ins Agency 8/12/08 101 S Main $75.00 Argonia, KS 67004 .;
Financial Strategies, Inc. 8/14/08 100 S 4th St. $75.00 Leavenworth, KS 66048 I
First Chicago Insurance Services 10/17/08 6811 Shawnee Mission Pkwy t/' $75.00 Overland Park,KS 66202
FirstComp Insurance Agency 9/30/08 935 Jefferson Blvd, Ste 300 $75.00 Warwick, RI 02886-2240 I
First Group Insurance, Inc. 8/12/08 136 S Broadway $75.00 Sterling, KS 67579 I .". .. $825.00 SubtQtal This Page - -
Page ~_ of~1_ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loan Other Other Receipt
First Insurance Agency 8/14/08 121 N Main .; $75.00 Cimarron, KS 67835
First Insurance Agency 9/19/08 108 E Main .; $75.00 Mount Hope, KS 67108
First Insurance of Leoti 8/12/08 Second & Broadway .; $75.00 Leoti, KS 67861
First Ins Agency of Hoxie, Inc. 8/12/08 PO Box 108 .; $75.00 Hoxie, KS 66740-0108
First State Insurance Agency 8/14/08 115 S Topeka .; $75.00 Burlingame, KS 66413
First Tribune Ins Agency, Inc. 9/5/08 118 W Greeley Ave. .; $75.00 Tribune, KS 67879
Flint Hills Insurance Agency 8/6/08 103 N Main $75.00 Eskridge, KS 66423 .;
Flury-Hinderks Ins Agency, Inc. 8/6/08 4601 College Blvd, Ste 120 .; $75.00 Shawnee Mission, KS 66211
Frederickson Insurance Agency 8/6/08 183 S Penn .; $75.00 Oberlin, KS 67749
Frewen Insurance Agency, Inc. 8/6/08 115 W Washington .; $75.00 S1. Francis, KS 67756
Fuqua Insurance Inc. 9/30/08 100 N Lancaster .; $75.00 Hesston, KS 67062
$825.00 SubtotalThisPage SCHEDULE A CONTRIBUTIONS A]\TJ) OTHER RECEIPTS
Kansas Insiurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loan Olher Other Receipt
Gall & Jones Insurance, Inc. 9/30/08 210 W Spruce .f $75.00 Dodge City, KS 67801-1206
Garry & Associates Ins Agency 8/14/08 135 E 20th Ave .f $75.00 Kansas City, MO 64116-3412
Gerber Insurance Group 9/5/08 5200 W 94th Terr, Ste 110 .f $68.75 Prairie Village, KS 66207
Gerstner Crop-Hail Ins., Gerald 8/6/08 300 E 10th S1. .f $75.00 Frankfort, KS 66427
Gill Agency, Inc., Jim 9/10/08 215 W Main .f $75.00 Cherryvale, KS 67335
Golden Age Insurance, Inc. 8/25/08 13025 S Mur-Len Rd, Ste 200 .f $75.00. Olathe, KS 66062
Goldenbelt Insurance Agency 8/20/08 12445 220 Road ,f $75.00 Belleville, KS 66935
Goodman Gravley Ins Source 8/20/08 14812 W 117th S1. $75.00 Olathe, KS 66062 .f
Graham-Rogers, Inc. 9/5/08 PO Box 1628 .f $75.00 Bartlesville, OK 74005
Grant County Ins. Agency,lnc. 8/12/08 112 W Central $75.00 Ulysses, KS 67880 .f
Great American Insurance Group 9/10/08 4910 Corporate Centre Dr., #200 $75.00 Lawrence, KS 66047 .f
$818.75 Subtotal This Page _c.
Page ~_ of2'1 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Cbeck Loan Otber Other Receipt
Gross Insurance Agency 9/10/08 105 S 4th .f $75.00 Manhattan, KS 66502-6109
Hagerty, Rose & McPherron, Inc. 9/3/08 106 W 11th St., #1250 .f $75.00 Kansas City, MO 64105
Halpin & Company 8/27/08 PO Box 7106 .f $75.00 Overland Park, KS 66207-0106
Hanston Insurance Agency, Inc. 8/27/08 POBox 189 .f $75.00 Hanston, KS 67849-0189
Hattrup Ag Services, Inc. 8/14/08 313 Colony .f $75.00 Kinsley, KS 67547
Harrison Brothers Agency, Inc. 8/6/08 900 N Morgan .f $75.00 Downs, KS 67437
Haven Insurance Agency, Inc. 8/12/08 101 ~I Kansas Ave $75.00 Haven, KS 67543 .f
Healy Insurance, Inc. 9/5/08 4004 W Hwy 4, Jayhawk Plaza $75.00 Healy, KS 67850-5060 .f
Heartland Adjustment, Inc. 8/14/08 PO Box 2666 .f $75.00 Salina, KS 67402
Heartland Crop Insurance 8/25/08 120 SE 6th, Ste 2-210 $75.00 Topeka, KS 66603 .f
Heartland Marketing Group 9/30/08 5050 Quorum Drive, Ste 500 .f $75.00 Dallas, TX 75254
., $825.00 l.'~ .s ubtotal This,.p.-age ~ .. """ ,. ." ,
Page -.J~ of 27 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Part)' Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Casb Check Loan Other Other Receipt
Heiman Insurance Agency 8/6/08 611 N 2nd St .f $75.00 Seneca, KS 66538
Heilman Insurance Agency 8/6/08 507 Court .f $75.00 Clay Center, KS 67432
Heinze & Associates Ins, Inc. 8/14/08 132 S Main .f $75.00 Lucas, KS 67648
Herrington Mutual Insurance 8/20/08 9 North Broadway .f $75.00 Herington, KS 67449
Heritage Ins Group, LLC/Logan 9/3/08 105 N Douglas .f $75.00 Logan, KS 67646
Herndon Ins Agency, Inc. 8/6/08 331 Quincy $75.00 Herndon, KS 67739 .f
Highland Ins Services Agency, Inc. 9/10/08 PO Box 38 $75.00 Highland, KS 66035-0038 .f
Holmes Insurance Agency 9/5/08 422 N Juliette Ave $75.00 Manhattan, KS 66505 .f
Hometown Ins Services, Inc. 8/6/08 126 E Central .f $75.00 Richmond, KS 66080
Houtz Agency, Inc. 8/14/08 709 Broadway $75.00 Marysville, KS 66508 .f
Hoxie State Insurance, Inc. 8/25/08 824 Main .f $75.00 Hoxie, KS 66740 - $825.00 Subtotal This P'age -
Page ---.2.?_ of2-2 SCHEDULE A CONTRIBUTIONS A.ND OTHER RECEIPTS
Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loan Other Other Receipt
Huggins Agency, Harley D. 8/25/08 3500 Gibbs Road .; $75.00 Kansas City, KS 66106-2116
ICI 8/6/08 120 W Central .; $75.00 EI Dorado, KS 67042
IMA of Kansas, Inc. 8/12/08 8200 E 32nd North .; $75.00 Wichita, KS 67226
Insurance, Inc. 8/25/08 11211 Johnson Dr. .; $75.00 Shawnee, KS 66203
Insurance Center 8/20/08 105 S Main .; $75.00 Hillsboro, KS 67063
Insurance Planning Center, Inc, 8/20/08 220 N Main .; $75.00 Eureka, KS 67045
Insurance Services, Inc. 8/14/08 101 N Main $75.00 Caldwell, KS 67022 .;
Insurance Solutions of KS, LLC 10/17/08 220 S 200th St. .; $75.00 Girard, KS 66743
Insurance Store/Edwards Agency 8/6/08 437 N Marshall .; $75.00 Chapman, KS 67431
Island Insurance, Inc. 8/14/08 PO Box 36 .; $75.00 Long Island, KS 67647-0036
J & D Insurance, Inc. 8/14/08 203 N Broadway .; $75.00 Lancaster, KS 66041 - ... $825.00 Subtotal Tills P Page~ of;?-{ SCHEDULE A CONTRIBUTIONS Al\TD OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than S150 Loan or Casb Cbeck Loan Otber Other Receipt J-K Agency 8/6/08 1307 E Iron .; $75.00 Salina, KS 67402 J & M Insurance Agency, LLC 8/14/08 105 B E Main .; $75.00 Harper, KS 67058 Janosik, Inc. 8/6/08 1415 Topeka Ave, Ste A .; $75.00 Topeka, KS 66612 Jelinek Insurance Agency 9/30/08 100 Main St. .; $75.00 Munden, KS 66959-0086 Jepson & Associates 8/20/08 307 Sycamore .; $75.00 Valley Falls, KS 66088 Johnson Insurance Agency 8/14/08 324 Liberty .; $75.00 Courtland, KS 66939 Johnson Ins Agency, Inc., Hank 8/25/08 3202 W 13th, Ste 1 $75.00 Wichita, KS 67203 I Johnston Fiss Insurance 9/3/08 5225 W 75th St, Ste 2QO .; $75.00 Shawnee Mission, KS 66208 Joyce, Jean A Agency 10/17/08 567 Diamond Springs Road .; $75.00 Denton, KS 66017 KASB Workers Comp Fund, Inc. 8/14/08 1420 SW Arrowhead Rd .; $75.00 Topeka, KS 66604 KBA Insurance, Inc. 8/6/08 610 SW Corporate View .; $75.00 Topeka, KS 66615 $82500 Subtotal This Page Page _~_ of 2.7 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Politcial Committee eN arne of Party Committee or Political Comm ittee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check LoaD Otber Other Receipt Kansas Farmers Service Assoc 8/20108 1515 E 30th ¥' $75.00 Hutchinson, KS 67502 Kansas Health Service Corp 9/19/08 215 SE 8th St. ¥' $75.00 Topeka, KS 66603 Kansas Medical Mutual Ins Co. 8/14/08 623 SW 10th St, Ste 200 ¥' $75.00 Topeka, KS 66612 Ks Resturant & Hospitality Assoc 9/10/08 3500 N Rock Road, Bldg 1300 ¥' $75.00 Wichita, KS 67226 Keller-Leopold Insurance, Inc. 8/6/08 302 Fleming, Ste 1 ¥' $75.00 Garden City, KS 67846 Kellerman Insurance, Inc. 9/3/08 101 W 4th St. ¥' $75.00 Holton, KS 66436 Kingman Insurance Agency 8/14/08 120 W B .; $75.00 Kingman, KS 67068 Kidney Insurance Agency, Inc. 8/20/08 9941 NW Hwy 24, Ste 2A $75.00 Silver Lake, KS 66539 .f Kimball Insurance Agency, Inc. 9/10/08 402 N Washington $75.00 Wellington, KS 67152 ¥' Kinban, Inc. 10/17/08 624 Coloney Ave $75.00 Kinsley, KS 67547 .f Kingrey-Kellum Agency, Inc. 8/20/08 1100 Military Ave $75.00 Baxter Springs, KS 66713 .f $825.00 Su.btoi!al This "Page SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Politcial Action Committee (Name of Pany Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individ ual Giving More Appropriate Box Cash, Check, Date of Contributor Than $]50 Loan or Loan Otber Cub Check Other Receipt KMIT/League of Municipalities 8/20/08 300 SW 8th Ave .f $75.00 Topeka, KS 66603 Klotz Agency, Inc. (The) 8/20/08 100 S 3rd St. .f $75.00 Leavenworth, KS 66048 Koger Agency, Inc, 8/6/08 7154 SW Wattling Ct. .f $75.00 Topeka, KS 66614 Kralicek Crop Insurance 8/6/08 103 First Street .f $75.00 Hunter, KS 67452 Kramer Agency, Inc. 8/6/08 106 Main .f $75.00 Ozawkie, KS 66070 L & W Andrist Ins Agency, LLC 9/5/08 102 E 8th .f $75.00 Goodland, KS 67735 Linn County Ins Agency, Inc. 8/12/08 PO Box 510 .; $75.00 LaCygne, KS 66040-0599 M. J. Kelly Company 8/27/08 4415 E Sunshine $75,00 Springfield, MO 65809 .f M & M Insurance 8/6/08 235 W 7th, #8 .f $75.00 Junction City, KS 66441 Marquette Ins. & R.E. Agency 9/10/08 205 N Washington $75.00 Marquette, KS 67464 .f MAX Insurance Agency 8/20/08 8717 W 11 Oth, #350 .f $75.00 Overland Park, KS 66210 $825.00 , ~U:btotal .. This Page .. SCHEDULE A CONTRIBUTIONS A.ND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loan Otber Other Receipt Maximum Insurance, LLC 8/12/08 126 W 8th t! $75.00 Horton, KS 66439 McCune-Robinson Insurance 8/25/08 10 S Steuben t! $75.00 Chanute, KS 66720 McGuire, Inc., Joe 9/10/08 1034 E 30th t! $75.00 Hutchinson, KS 67502 Meadowbrook Ins Group 8/14/08 11880 College Blvd, Ste 500 t! $75.00 Overland Park, KS 66210 Med James, Inc. 9/10/08 8595 College Blvd, Ste 200 t! $75.00 Overland Park, KS 66210 Mellick Agency, L.P., E.C. 8/6/08 415 State t! $75.00 Atwood, KS 67730 Metheny & Associates, John 8/12/08 10101 Connell Drive $75.00 Overland Park, KS 66212 I MetLife Auto & Home 9/30/08 10801 Mastin Blvd, #600 $75.00 Overland Park, KS 66210 t! Mid-America Risk Managers 9/30/08 5036 S 136th St. $75.00 Omaha, NE 68173 t! Midland Insurance Group, Inc. 9/3/08 2969 W 13th St. North $75.00 Wichita, KS 667203-6618 t! Midwest Ins Agency Alliance, Inc. 9/10/08 6128 Havelock Ave t! $75.00 Lincoln, NE 68507 $825.00 Subtotal~This Page. SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Check Loan Other Cub Other Receipt Midwest Ag Professionals, Inc. 8/6/08 28236 SW KK Rd, South Hwy 283 .; $75.00 Jetmore, KS 67854 Mid-Continent Group 8/14/08 1437 S Boulder, Ste 200 .; $75.00 Tulsa, OK 74119 Miller Ins Agency, Robert E. 8/14/08 373 W 101st Terr., #200 .; $75.00 Kansas City, Mo 64114-4408 Miner Brothers Company 9/19/08 101 S Pennsylvania Ave .; $75.00 Ness City, KS 67560 Murphy Insurance Agency 8/25/08 1617 VV 27th Street .; $100.00 Lawrence, KS 66046 NAU Country 8/12/08 400 NVV Curtis .; $75.00 Topeka, KS 66608 NCMIC Finance Corporation 8/27/08 14001 University Ave .; $75.00 Clive, IA 50325 Nason Associates, Inc. 8/27/08 5700 Broadmoor, #905 .; $75.00 Mission, KS 66202 New Century Ins Group, Inc. 8/14/08 14161 S Mur-Len Rd. .; $75.00 Olathe, KS 66063 New Horizon Insurance 9/19/08 1416 Old Main .; $75.00 Newton, KS 67114 Newkirk, Dennis & Buckles, Inc. 8/6/08 304 N Penn Ave .; $75.00 Independence, KS 67301 $850.00 .' Subtotal Tbls Paoe.e " P'O! . Paoeb 19 of~-r_ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than 51 SO Loan or Cash Check Loan Other Other Receipt Norris Training Systems 9/30/08 400 N Woodlawn, #111 .; $75.00 Wichita, KS 67208 Northeast Kansas Ins Agency 8/12/08 520 Main St. .; $75.00 Nortonville, KS 66060-0328 North American Group 8/20/08 PO Box 25928 .; $75.00 Oklahoma City, OK 73125 North American Software Assoc. 8/12/08 104 Owen St. .; $75.00 Belgrade, MN 56312 Old United Casualty 8/14/08 8500 Shawnee Mission Pkwy .; $75.00 Merriam, KS 66202 Oliver Insurance Agency, Inc. 10/17/08 6201 CoBege Blvd, #230 .; .$75.00 Overland Park, KS 66211 O'Malley Insurance Services, LLC 9/3/08 7610 Canterbury .( $75.00 Prairie Village, KS 66208 Palmer Insurance Agency 8/6/08 104 E 2nd .; $75.00 Palmer, KS 66962 Paxico Insurance Agency 8/27/08 117 Newbury Ave .; $75.00 Paxico, KS 66526 Personal Service Insurance, Inc. 8/6/08 211 South Street .; $75.00 lola, KS 66749 Perz & Associates, LLC, Mike 8/14/08 11944 W 95th St., #112 .; $75.00 Lenexa, KS 66215 II $825.00 ~ Subtotal This Page ,', . Page _~ of.2-~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loan Otber Other Receipt Pickett Insurance Services 8/20/08 124 E Main .; $75.00 Independence, KS 67301 Plainville Insurance, LLC 8/14/08 218 W Mill I $75.00 Plainville, KS 67663 Porter Crop Insurance, Inc. 9/5/08 9010 1650 Road I $75.00 Fredonia, KS 66736 Porter-Spears & Bundy, Inc. 8/6/08 310 S Main .; $75.00 Ottawa, KS 66067 Post Insurance, Inc. 9/5/08 106 Main .; $75.00 Paradise, KS 67658 Powell & Associates, David J. 8/6/08 6872 NE Cole Creek Road .; $75.00 EI Dorado, KS 67402 Power Group Risk Services, LLC 8/25/08 12721 Metcalf Ave, Ste 103 .; $75.00 Overland Park, KS 66213 Prairie Land Insurance Agency 8/14/08 PO Box 67 .; $75.00 Winona, KS 67764-0067 Premium Financing Specialists 9/3/08 13520 Wyandotte .; $75.00 Kansas City, MO 64145 Producers Ag Insurance Group 9/5/08 16011 College Blvd, Ste 210 .; $75.00 Lenexa, KS 66219 Producers XL 8/6/08 PO Box 646 .; $75.00 Salina, KS 67402-0646 ." $825.00 ., .. Subtot-al This Page Page _~_1_ of~1 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Casb Check Loan Otber Other Receipt Professional Ins Management Inc. 8/14/08 2120 Airport Rd, 2nd Floor .( $75.00 Wichita, KS 67209 Progressive Companies 8/20/08 12980 Foster St., Ste 100 .( $75.00 Overland Park, KS 66213 R & W Agency, Inc. 9/5/08 120 S Main St. .( $100.00 Inman, KS 67546-0488 Rain & Hail LLC 9/30/08 14517 F St., Ste 213 .( $75.00 Omaha, NE 668137-1055 Raleigh Insurance Agency, Inc. 8/14/08 340 Main St. .( $75.00 Little River, KS 67457-0337 Reilly & Sons, Inc. 8/14/08 608 Delaware .( $75.00 Leavenworth, KS 66048 Renn & Company, Inc. 9/19/08 PO Box 40 ..; $75.00 Wellington, KS 67152 Riegel Insurance, Inc. 8/25/08 523 Main St. .( $75.00 Ford, KS 67842 Risk Management Partners 8/6/08 402 Main .( $75.00 Mound City, KS 66056 Rodenbeek & Green Agency 8/6/08 601 Main St. .( $75.00 Scott City, KS 67871 Romme Agency, Inc. 8/14/08 1008 E 17th St. ;:('\ :3 Page~of2-1 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) OccupatiOD & Industry of Cbeck Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loan Other o tber Receipt Rush County Ins Services, Inc. 8/6/08 821 Main ~ $75.00 La Crosse, KS 67548 Russell Insurance Agency 8/14/08 1000-3 North Main ~ $75.00 Lansing, KS 66043 Rutter-Cline Associates, Inc. 8/14/08 312 N 8th ~ $75.00 Garden City, KS 67846 SBAIC dba Howell Insurance 8/14/08 713 Main ~ $75.00 Ashland, KS 67831 SBS Insurance Agency 8/12/08 502 Main ~ $75.00 Seneca, KS 66538 Safeco Insurance 9/10/08 7201 W 129th St. ~ $75.0.0 Overland Park, KS 66213 Salina Insurance Services 9/3/08 157 N 9th $75.00 Salina, KS 67401 ..; Santa Fe Agricultural Services 8/6/08 1003 West Main ~ $75.00 Council Grove, KS 66846 Saylor Insurance Service, Inc. 8/6/08 21 Main, Morrill State Bank ~ $75.00 Sabetha, KS 66534 Sentry Insurance/Dairyland 8/27/08 4184 Indianhead Rd ~ $75.00 Grand Island, NE 68803 Sewing & Co., Inc., HW. 8/27/08 1314 N 5th St., Ste 201 ~ $75.00 Kansas City, KS 66101 1'- $825.00 Subtotal This Paue , .". .. ~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name ofPany Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or CaslJ Check Loan Other Other Receipt Schifman, Remley & Assoc, Inc. 8/14/08 5201 Johnson Dr., Ste 500 $75.00 Lenexa, KS 66205 Schulte Agency, Inc., CD. '" 9/10/08 PO Box 306 $75.00 Garnett, KS 66032-0306 Scribner Insurance Agency, LLC '" 8/14/08 320 Friend St. $75.00 Cottonwood Falls, KS 66845 Sherman Insurance Agency, Inc. '" 9/5/08 PO Box 105 $75.00 Lyons, KS 67554-0105 Siebers & Co., Inc., George J. '" 8/6/08 8500 Shawnee Mission Pkwy $75.00 Mission, KS 66202 Signature Personal Ins, LLC '" 8/20/08 5402 Brich $75.00 Mission, KS 66222 Sims Insurance Services, Inc, '" 8/20/08 PO Box 369 $75.00 Maize, KS 67101 Smart Insurance Services '" 9/5/08 300 N Cedar $75.00 Abilene, KS 67410 Smith County Ins Services '" 9/3/08 136 S Main $75.00 Smith Center, KS 66967-0307 Smith-Guth Insurance Agency '" 8/6/08 507 Lincoln Ave $75.00 Wamego, KS 66547 Southern Kansas Agency, Inc. '" 8/6/08 131 E Randolph $75.00 Howard, KS 67349 ~ '" $825.00 ..... ~.!1btotaIThis Page Page~~oCn SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Agents Committee (Name of Pan)' Committee or Political Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Cbeck Loan Other Other Receipt State Auto Ins Companies 9/19/08 1300 Woodland Ave ~ $75,00 West Des Moines, IA 50265 Stephen's Insurance 8/6/08 2711 W 6th St, Ste A ~ $75,00 Lawrence, KS 66049-4306 Stephenson & Meyer Ins Agency 8/25/08 5750 W 95th St, Ste 100 ~ $75,00 Overland Park, KS 66207 Strutt Ins Serv.lF&M Ins, Store 8/14/08 990 S Range, Suite 28 ~ $75,00 Colby, KS 67701 Sullivan Insurance, Inc. 8/14/08 123 W Central, Ste A ~ $75.00 Ulysses, KS 67780-2519 Summit Insurance Group 9/3/08 3 SE 3rd Street ~ $75.00 Lees Summit, MO 64063 Sunflower Insurance Group, Inc, 8/25/08 217 S Santa Fe ~ $75,00 Salina, KS 67401 Surety Support Services, Inc, 8/6/08 7255 W 98th Terr, Ste 170 ~ $75,00 Overland Park, KS 66212-2200 TWI & Dietz, Inc, 9/30/08 120 N Main St ~ $75.00 WaKeeney, KS 67672 Tallman Insurance Agency 8/25/08 406 W 34th St., Ste 806 ~ $75,00 Kansas City, MO 64111 Thomas McGee, LC 8/20/08 920 Main, Ste 1700 ~ $75.00 Kansas City, MO 64105 " $825.00 :Subtotal This Page '" Page~of~ SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS (N arne of Party Committee or p--gjitical Committee) ., Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loall Otber Other Receipt Tozier Parkway Housh Jones 9/5/08 5750 W 95th St., Ste 105 .; $75.00 Overland Park, KS 66207 Travelers Insurance 9/3/08 940 Westport Plaza, Ste 450 .; $75.00 St. Louis, MO 63146 Tyler Agency, Inc., C. Ray 8/25/08 1999 N Amidon, Ste 121 .; $75.00 Wichita, KS 67203 United Agency, Inc. 8/12/08 726 N Summit .; $75.00 Arkansas City, KS 67005 United Fire Group 9/19/08 118 2nd Ave. SE .; $75.00 Cedar Rapids, IA 52407 Upland Mutual Insurance, Inc. 9/10/08 2220 Lacy Drive .; $75.00 Junction City, KS 66441-7574 Van Hercke Insurance Agency, Inc. 8/6/08 11807 College Blvd $75.00 Overland Park, KS 66210-1314 v' Waverly Insurance Agency, Inc. 8/20/08 309 Pearson .; $75.00 Waverly, KS 66871 Western Shelter Insurance, Inc. 8/14/08 301 East Beatty .; $75.00 Johnson, KS 67855 Westrope & Associates 8/12/08 801 W 47th St., #500 .; $75.00 Kansas City, MO 64112 Whitehead & Associates 9/3/08 5112 E Central .; $75.00 Wichita, KS 67208 I,.. $825.00 ·i Subtotal This Page _...... ... -- ~- Page_~ of...zl SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Insurance Agents Political Action Committee (Name ofPany Committee or Polirical Committee) Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Cash Check Loan Otber Other Receipt Wichita Roofing 8/6/08 3821 Bounous .; $75.00 Wichita, KS 67213-1202 Williams Insurance, Inc., Bob 8/6/08 1900 S Main .; $75.00 Fort Scott, KS 66701 Wright Insurance, Inc., Wayne 9/19/08 616 W Douglas .; $75.00 Wichita, KS 67203-1507 Wolf Agency, Irvin 10/17/08 802 Hillside Drive .; $75.00 Quinter, KS 67752 Xanatek, Inc. 9/30/08 PO Box 160 .; $75.00 Granger, IN 46530 Continental Western Group 8/20/08 3641 Village Dr. .; $75.00 Lincoln, NE 68516 Jeff Whitham for Representative Check Returned 6/26/08 1308 Cloud Drive $100.00 Garden City, KS 67846 Vision Bank Interest 712 S Kansas Ave $444.95 Topeka, KS 66603 $994.95 Subtotal This Pag:e Complete if last page of Schedule A Total Itemized Receipts for Period $23,357.45 Total Unitemized Contriburions (S50 or less) $1,762.75 Sale of Political Materials (Unitemized) Taral Conrributions When Contributor Not Known TOTAL RECE-IPTS THIS PERIOD (to line '2 of Summary) $25,120.20 Page ---,!!__ of2--~ SCHEDULEB IN-KIND CONTRIBUTIONS Kansas Insurance Agents Political Action Committee (Name of Parry Committee or Political Committee) List Occupation & Value of Date Name and Address Industry for Those Giving Description of In-Kind In-Kind of Contributor an In-Kind of More Than Contribution Contribution $150 '~ .~ "~..;- ..,. ~; '~,' "- :'.' l -'. ' - $0,00 Subtotal This Page c,' ...... ,. ':;;; .'1 ~b - - .. it >",-'1' - -- Complete if last page of Schedule B Total Itemized (over $100) In-Kind Contributions $0,00 Total Unitemized ($100 or less) In-Kind Contributions -, TOTAL IN-KIND CONTRIBUTIONS THIS PERIOD (to line 6 of Summary) $0.00 SCHEDULE C EXPEI\TJ)ITURES Al'\TJ) OTHER DISBURSEMENTS Kansas Insurance Agents Political Action Committee (Name of Parry Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 Kathleen Sebelius Committee Donation 8/7/08 PO Box 4302 $1,000.00 Topeka, KS 66604-0302 IRS Tax Form 1120 8/12/08 Ogden, UT 84201-0039 $351.00 Peter DeGraf Campaign Fund Donation 8/28/08 1545 E 119th $500.00 Mulvane, KS 67110 Carolyn McGinn Donation 9/3/08 11047 N 87th St. W $500.00 Sedgwick, KS 67135 Ronnie Metsker for Rep Donation 9/3/08 5223 Foster $350.00 Overland Park, KS 66202 Dennis D Pyle for Senate Donation 9/9/08 2979 Kingfisher Rd $500.00 Hiawatha, KS 66434 Marci Francisco for Senate Donation 9/9/08 1101 Ohio $500.00 Lawrence, KS 66044 Roger C Pine for Senate Donation 9/9/08 1783 E 1500 Rd $500.00 Lawrence, KS 66044 Steve Fitzgerald for Senate Donation 9/9/08 3100 Tonganoxie Rd $500.00 Leavenworth, KS 66048 Tim Owens for Senate Donation 9/9/08 7804 W 100th St. $500.00 Overland Park, KS 66212 . , $5,201.00 Subtotal This Page ~ - Paoeo 1 of q_ SCHEDULE C EXPKNDITURES Al\'D OTHER DISBURSEMENTS Kansas Insurance Agents Political Action Committee (Name of Parry Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 Julia Lynn for Senate Donation 9/9/08 18837 W 115th Terr $500.00 Olathe, KS 66061 Mary Pilcher Cook for Senate Donation 9/9/08 13910 W 58th Place $500.00 Shawnee, KS 66216 John Vratil for Senate Donation 9/9/08 9534 Lee Blvd $500.00 Leawood, KS 66206 Pat Apple for Senate Donation 9/9/08 PO Box 626 - $500.00 Louisburg, KS 66053 Bob Marshall for Senate Donation 9/9/08 PO Box 1131 $500.00 Fort Scott, KS 66701 Dwayne Umbarger for Senate Donation 9/9/08 1585 70th Rd $500.00 Thayer, KS 66776 Jim Barnett for Senate Donation 9/9/08 1400 Lincoln $500.00 Emporia, KS 66801 Laura Kelly for Senate Donation 9/9/08 234 SW Greenwood Ave $500.00 Topeka, KS 66606 Vicki Schmidt for Senate Donation 9/9/08 2619SW Randolph Ct. $500.00 Topeka, KS 66611 Mark Taddiken for Senate Donation 9/9/08 2614 Hackberry Road $500.00 Clifton, KS 66937 Roger P Reitz for Senate Donation 9/9/08 1332 Sharingbrook $500.00 Manhattan, KS 66503 - $5,500.00 .'~ Subtotal This Page Page _2__ ofl_ SCBEDULEC EXPEl\'DITURES Al\'D OTHER DISBURSE1VffiNTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 Karin Brownlee for Senate Donation 9/9/08 14725 S Chalet Dr. $500.00 Olathe, KS 66062 Pete Brungart for Senate Donation 9/9/08 522 Fairdale Rd $500.00 Salina, KS 67401 Jean Kurtis Schodorf for Senate Donation 9/9/08 3039 Benjamin Ct. $500.00 Wichita, KS 67204 Dick Kelsey for Senate Donation 9/9/08 24047 W MacArthur $500.00 Goddard, KS 67052 Leslie D Donovan Sr. for Senate Donation 9/9/08 314 N Rainbow Lake $500.00 Wichita, KS 67235 Mike Peterson for Senate Donation 9/9/08 2608 Southeast Dr. $500.00 Wichita, KS 67216 Kenya Cox for Senate Donation 9/9/08 2745 N Fountain $500.00 Wichita, KS 67220 Susan Wagle for Senate Donation 9/9/08 4 Sagebrush $500.00 Wichita, KS 67230 Ruth Teichman for Senate Donation 9/9/08 434 E Old Highway 50 $500.00 Stafford, KS 67578 Terry .Bruce for Senate Donation 9/9/08 401 E Sherman $500.00 Hutchinson, KS 67501 Jay Elmer for Senate Donation 9/9/08 1457 Shawnee Road $500.00 - Lindsborg, KS 67456 I' $5,500.00 Subtotal This Page ," ~. - SCHEDULEC EXPE1\TDITURES AND OTHER DISBURSE:MENTS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 Janis K Lee for Senate Donation 9/9/08 203290 Road $500.00 Kensington, KS 66951 Jeff Colyer for Senate Donation 9/9/08 7001 W 121 st $500.00 Overland Park, KS 66223 Tim Huelskamp for Senate Donation 9/9/08 PO Box 379 $500.00 Fowler, KS 67844 Stephen R Morris for Senate Donation 9/9/08 600 Trindle Street $500.00 Hugoton, KS 67951 Robert Grant for Representative Donation 9/9/08 407 W Magnolia $350.00 Cherokee, KS 66724 Lynne OHarah for Representative Donation 9/9/08 2120 95th St. $350.00 Uniontown, KS 66779 John Coen for Representative Donation 9/9/08 4418 Nebraska Terrace $350.00 Wellsville, KS 66092 Virgil Peck Jr. for Representative Donation 9/9/08 PO Box 277 $350.00 Tyro, KS 67364 Jeff King for Representative Donation 9/9/08 1212 N Second Street $350.00 Independence, KS 67301 Lance Kinzer for Representative Donation 9/9/08 12549 S Brougham $350.00 Olathe, KS 66062 Arlen Siegfreid for Representative Donation 9/9/08 1403 W Prairie Terr "$350.00 Olathe, KS 66061 $4,450.00 SuMotaI This Pllge ". SCHEDULEC EXPEl\TDITURES AND OTHER DISRURSEl\ffiNTS Kansas Insurance Agents Political Action Committee (N arne of Party Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 Jim Yonally for Representative Donation 9/9/08 10039 Mastin Dr. $350.00 Overland Park, KS 66212 John Skubal for Representative Donation 9/9/08 11319 Hemlock $350.00 Overland Park, KS 66210 Kay Wolf for Representative Donation 9/9/08 8339 Roe $350.00 Prairie Village, KS 66207 August Bogina III for Rep. Donation 9/9/08 6814 Bluejacket $350.00 Shawnee, KS 66203 Terrie W Huntington for Rep. Donation 9/9/08 5701 Mission Rd. $350.00 Fairway, KS 66205 Ray Merrick for Representative Donation 9/9/08 6874 W 164th Terr $500.00 Stilwell, KS 66085 Pat Colloton for Representative Donation 9/9/08 2513 W 118th Street $350.00 Leawood, KS 66211 Ron Worley for Representative Donation 9/9/08 8957 Woodstone $350.00 Lenexa, KS 66219 Anthony R Brown for Rep. Donation 9/9/08 1229 Acom $500.00 Eudora, KS 66025 Owen Donohoe for Rep. Donation 9/9/08 6265 Arapahoe St. $350.00 Shawnee, KS 66226 Connie O'Brien for Representative Donation 9/9/08 22123 211th Street $350.00 Tonganoxie, KS 66086 -. $4,15000 Subtotal TlLis Page ..... , Page_5_of~ SCHEDULEC EXPEl\'DITURES Al\'D OTHER DISBURSEME1\T TS Kansas Insurance Agents Political Action Committee (N arne of Party Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 S. Mike Kiegerl for Rep. Donation 9/9/08 2350 Golf Course Rd $350.00 Olathe, KS 66061 Tom Sloan for Representative Donation 9/9/08 772 Hwy 40 $100.00 Lawrence, KS 66049 Marvin G Kleeb for Rep. Donation 9/9/08 14206 Eby $350.00 Overland Park, KS 66221 Scott Schwab for Representative Donation 9/9/08 14953 W 140th Terr $350.00 Olathe, KS 66062 Lana Gordon for Representative Donation 9/9/08 5820 SW 27th St $350.00 Topeka, KS 66614 Joe Patton for Representative Donation 9/9/08 3546 SW Summerwood Ct. $350.00 Topeka, KS 66614 Barbara Craft for Representative Donation 9/9/08 110 South Garfield $350.00 Junction City, KS 66441 Jim Irey for Representative Donation 9/9/08 2376 E 333rd $350.00 Melvern, KS 66510 Sydney Carlin for Representative Donation 9/9/08 1650 Sunnyslope Lane $200.00 Manhattan, KS 66502 J Robert Brookens for Rep Donation 9/9/08 201 Meadow Lane $250.00 Marion, KS 66861 Charlie Roth for Representative Donation 9/9/08 3 Crestview Dr. $350.00 Salina, KS 67401 .' $3,350.00 SuMotal This Page Page __6_ of~_ SCHEDULEC EXPKNDITURES AND OTHER DISBURSENIENTS Kansas Insurance Agents Political Action Committee (Name of Part)' Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 Marc Rhoades for Representative Donation 9/9/08 1006 Lazy Creek Drive $350.00 Newton, KS 67114 Clark Schultz for Representative Donation 9/9/08 707 Washington Circle $500.00 Lindsborg, KS 67456 Don Schroeder for Representative Donation 9/9/08 131 14th Ave $350.00 Inman, KS 67546 John C Grange for Representative Donation 9/9/08 1115 Rim Rock Road $350.00 EI Dorado, KS 67042 Peggy L Mast for Representative Donation 9/9/08 765 Road 110 $350.00 Emporia, KS 66801 Kasha Kelley for Representative Donation 9/9/08 PO Box 1111Nalley View $350.00 Arkansas City, KS 67005 Don V Myers for Representative Donation 9/9/08 613 Briarwood $350.00 Derby, KS 67037 JoAnn Pottorff for Representative Donation 9/9/08 6321 E 8th $350.00 Wichita, KS 67208 Steven Brunk for Representative Donation 9/9/08 4430 Janesville $350.00 Bel Aire, KS 67220 Steve Huebert for Representative Donation 9/9/08 619 N Birch $350.00 Valley Center, KS 67147 Brenda Landwehr for Rep. Donation 9/9/08 2837 N Edwards St. $500.00 Wichita, KS 67204 $4,150.00 Subtotal This Pllge • L ...... .Page _7_ of--=t._ SCHEDULE C EXPKNDITURES Al\TJ) OTHER DISBURSE1VrENTS Kansas Insurance Agents Political Action Committee (Name ofPany Committee or Political Committee) Purpose of Expenditure Date Name and Address List candidate name & address if independent or in-kind Amount expenditure in excess of $300 Aaron Jack for Representative Donation 9/9/08 1330 N Robin Ct. $350.00 Andover, KS 67002 Dan Kerschen for Representative Donation 9/9/08 645 S 263 W $350.00 Garden Plain, KS 67050 Joe Seiwert for Representative Donation 9/9/08 1111 E Boundary Road $350.00 Pretty Prairie, KS 67570 Michael R O'Neal for Rep. Donation 9/9/08 8 Windemere $250.00 Hutchinson, KS 67502 Jason P Watkins for Rep. Donation 9/9/08 6525 W Northwind St. $350.00 Wichita, KS 67205 Bill Wolf for Representative Donation 9/9/08 1512 Broadway Court $350.00 Great Bend, KS 67530 Bob Bethell for Representative Donation 9/9/08 PO Box 186 $350.00 Alden, KS 67512 Melvin J Neufeld for Rep. Donation 9/9/08 7405 15 Rd $250.00 Ingalls, KS 67853 Don Hineman for Representative Donation 9/9/08 116 S Longhorn Rd $250.00 Dighton, KS 67839 Pat George for Representative Donation 9/9/08 3007 Westview $350.00 Dodge City, KS 67801 John M Faber for Representative Donation 9/9/08 HC 2 Box 130 $350.00 Brewster, KS 67732 $3,550.00 Subtotal This Page t .;" - Page _8_ ofJ_ SCHEDULEC EXPE1\'DITURES AND OTHER DISBURSEMENTS Kansas Insurance Agents Political Action Committee ( Name of Parry Committee or Political Committee) Purpose of Expenditure Amount Name and Address Date List candidate name & address if independent or in-kind expenditure in excess of $300 Ty Masterson for Senate Donation 9/9/08 1539 Phyllis Lane $900.00 Andover, KS 67002 Kevin Yoder for Representative Donation 9/9/08 5817 W 100th Terrace $350.00 Overland Park, KS 66207 Deena L Horst for Representative Donation 9/9/08 920 S 9th $350.00 Salina, KS 67401 John Rubin for Representative Donation 9/29/08 13803 W 53rd S1. $350.00 Shawnee, KS 66216 Ron Thornburg for Sec of State Donation 10/3/08 105 SW Greenwood $250.00 Topeka, KS 66606 Virgil Peck, Jr. for Representative Donation 10/3/08 PO Box 277 $150.00 Tyro, KS 67364 $2,350.00 Subtotal This Page Complete if last page of Schedule c Total Itemized Expenditures This Period $38,201.00 Total Unitemized Expenditures of $50 or less $75.16 TOTAL EXPENDITURES & OTHER DlSBURSEMENTS $38,276.16 . THIS PERIOD (to line 4 of Summary) Page __9_ oC~ SCHEDULED OTHER TRANSACTIONS Kansas Insurance Agents Political Action Committee (Name of Party Committee or Political Committee) Balance at Date Name and Address Nature of Account or Loan Payable Close of or Loan Receivable Period ,., ...... ~. -. _" Complete if last page of Schedule D TOTAL OTH.ER TRANSACTIONS (to line 7 of Summary) $0.00 Page __1 _ of~