803 Christy Gilbert Holstege 2020-01-02 Renova EnergyRECEIVED
Behested Payment Report A PuWjt;jpgt*wrA SPRINGS
1. Elected Officer or CPUC Member (Last name. First name) tot P
Christy Gilbert Holstege 2020 JAN - PM �� � �
Agency Name
City of Palm Springs OFFICE OF T' CITY CLE
3200 E Tahquitz Canyon Way
(Name and title,
Christy Gilbert Holstege
(760) 323-8299 1 christy.holstege@palmspringsca.gov
❑ Amendment (See Pads)
6ehested Payment Report
For Official Use Only
Date of Original Filing:
(nwMh. day, y80
2. Payor Information (For additional payers. include an attachment with the names and addresses.)
Renova Energy
75181 Mediterranean Palm Desert CA 92211
Address City Stale Lp Code
3. Payee Information (For additional payees. include an attachment with the names and addresses)
Equality California
Name
3701 Wilshire Blvd, Suite 725 Los Angeles CA 90010
Address C'W State Zip code
4. Payment Information (Completealimforni.hon.)
Date of Payment: 11/12/2019 Amount of Payment: (#,4aodFMv) $ 5'000
(month, day, year) (Round to whole dollars.)
Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services (Provide description betow)
Brief Description of In -Kind Payment:
Purpose: (Check one and provide descrithondetow) ❑Legislative ❑Governmental ®Charitable
Describe the legislative, governmental, charitable purpose, or event: Equality California Palm Springs Awards
2019
5. Amendment Description and/or Comments
I was notified on 12/12/2019 that this was received by the payee.
6. Verification
I certify, under penalty of perjury under the laws of the State of California, that to the best of my knowledge, the information contained
herein is true and complete.
Executed on 1/2/20�
DATE
By IGMTU ELMOFFICER OR CFM ME
17 FPPC Forth 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)