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HomeMy WebLinkAbout3B - Additional Material1.Name of Entity PUBLIC INTEGRITY DISCLOSURE APPLICANT DISCLOSURE FORM We Are One United Inc. 2.Address of Entity (Principle Place of Business) 7398 Marshall Ct, Highland CA 92346 3.Local or California Address (if different than #2) 1905 E. Tahquitz Canyon Way, Unit 3, Palm Springs, CA 92262 4.State where Entity is Registered with Secretary of State California If other than Cal ifornia, is the Entitv also reqistered in California? n Yes n No 5.Type of Entity 181 Corporation D Limited Liability Company D Partnership D Trust D Other (please specify) 6.Officers, Directors, Members, Managers, Trustees, Other Fiduciaries (please specify) Note: If any response is not a natural person, please identify all officers, directors, members, managers and other fiduciaries for the member, manager, trust or other entity Officers: Please see attached list of Board officers and Directors Ownership: 100 % We Are One United Inc, a California Corporation �fficer [],director D Member D Manager (Revised 09 13 18) [n�me] D General Partner D Limited Partner □other D Officer D Director D Member D Manager [name] D General Partner D Limited Partner □Other D Officer D Director D Member D Manager [name] D General Partner D Limited Partner □Other CITY OF PALM SPRINGS-PUBLIC INTEGRITY DISCLOSURE APPLICANT DISCLOSURE FORM Page 1 of 2 Item 3B - Additional Material 7.Owners/Investors with a 5% beneficial interest in the Applicant Entity or a related entitv EXAMPLE JANE DOE 50%, ABC COMPANY, Inc. [name of owner/investor] [percentage of beneficial interest in entity and name of entity] A. [name of owner/investor] [percentage of beneficial interest In entity and name of entity] B. [name of owner/investor] [percentage of beneficial interest in entity and name of entitvl C. [name of owner/investor] [percentage of beneficial interest in entity and name of entity] D. - [name of owner/investor] [percentage of beneficial interest in entity and name of entitv] E. (name of owner/investor] [percentage of beneficial interest in entity and name of entitvl I DECLARE UNDER PENAL TY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. (Revised 0913 18) Date CITY OF PALM SPRINGS -PUBLIC INTEGRITY DISCLOSURE APPLICANT DISCLOSURE FORM Page 2 of 2 Item 3B - Additional Material We Are One United Board of Directors List Mr. John Epps, CEO We Are One United Inc Executive Director jepps@weareoneunitedinnovation.org (909)499-5536 Mr. Matthew Mark Campos, Board Chair Desert Best Friend's Closet Palm Desert, CA Executive Director matthewm. cam pos@gmail.com (760)464-5636 Ms. Luz Moreno, Board Secretary lnnerCare Coachella, CA Community Engagement Program Manager bestitaever@gmail.com (760)960-4349 Ms. Lauren Bruggemans, Board Treasurer Visit Greater Palm Springs Palm Springs, CA Director of Sustainability & Community Engagement laurenb@visitgreaterps.com (760)969-1336 Mr. Alex Avila, Member California State University-San Bernardino San Bernardino, CA Instructor alex.avila4e@gmail.com (909)713-3145 Mr. Scott Cooper, External Relations Committee Chair College of the Desert Ranch Mirage, CA Dean of Student Success and Transfer Counselor scooper@collegeofthedesert.edu (760)776-7453 Ms. Jennifer Braun, Board Member CFO Nonprofit Consulting Services Palm Desert, CA Owner jbraun@cfononprofitservices.com (760)288-1308 Item 3B - Additional Material Ms. Cristina Gregorio, Board Member One Future Coachella Valley Palm Desert, CA Director Of College and Career Success cristina@onefuturecv.org (760)625-0449 Ms. Anyse Smith, Board Member Coachella Valley Association of Governments Palm Desert, CA Corresponding Secretary anyse.smith@gma1l.com (760)625-0449 Item 3B - Additional Material