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HomeMy WebLinkAbout803 Lisa Middleton 2019-12-30 Renova EnergyBehested Payment Report A Public Document Behested Payment Report 1. Elected Officer or CPUC Member (Last name, First name) Date Stamp7ForCffidal , Lisa Middleton E C E I Y E D F PALM SPRINGy Agency Name City of Palm Springs 20190 C 30 PIN 4: 55 Agency Street Address 3200 Tahquitz Canyon Way, Palm Springs CA 92262 OFFICE F THE CITY CLER. Designated Contact Person (Name and title, ifditrerent) ❑ Amendment (see Pen 5) Area Code/Phone Number E-mail (Optional) Date of Original Filing: 760-507-7851 lisa.middleton@palmspringsca.gov (a°°a' `•y,) 2. Payor Inform n (For additional payors, include an attachment wttp the names and addresses.) 1J 0 `7 (Sl ES L "1 Name Address CRY state Zip Code 3. Payee Information (For additional payees, include an attachment with the names and addresses.) Equality California Name 3701 Wilshire Blvd. # 725 Los Angeles CA 90010 Addrais City State Zip Code 4. Payment Information (comptateall information) cc o Date of Payment: I t � +Z l� C l � Amount of Payment: (in-ICIndFMU/ $ 4"� (month, day, year) (Round to whole doaam ) Payment Type: I@ Monetary Donation or ❑ In -Kind Goods or Services (Pmvide description below) Brief Description of In -Kind Payment: Purpose:(CheckoneendpmNdedescdp6on below.) ❑Legislative ❑Governmental ❑O Charitable Describe the legislative, governmental, charitable purpose, or event: Donation to Equality California 2019 Palm Springs Awards Gala 5. Amendment Description and/or Comments I was not made aware of this contribution until December 19, 2019. 6. Verification I certify, under penalty of perjury under the laws of the State of herein is true and complete. December 30, 2019 Executed on DATE that to the best of my knowledge, the information contained FPPC Form 803 (January/2018) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)