803 Geoff Kors 2019-11-04 Eisenhower HealthBehested Payment Report A Public Document Behested Payment Report
1. Elected Officer or CPUC Member (Last name, First name) t�r�p� e
Kors, Geoff CITY 0 PAL KIrtGS rr •
Palm Springs City Council
3200 E. Tahquitz Canyon Way
Area Code/Phone
7605370061
Eisenhower Health
(Optional)
2019NON 84 PM 4-- 48
THE CITY CLEM
❑ Amendment (Sea Pan 5)
For Official Use Only
Date of Original Filing:
(month, day, year)
(For additional payors, include an attachment with the names and addresses.)
39000 Bob Hope Drive Rancho Mirage CA 92270
Address City State Zip Code
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California
3701 Wilshire Blvd #725
Los Angeles
CA 90010
Address City State Zip Code
4. Payment Information (Complete all information)
Date of Payment: 10/15/19 Amount of Payment: (in -Kind PM) $ 25,000
/month. day, year) (Round to whole dotlam.)
Payment Type: 0 Monetary Donation or ❑ In -Kind Goods or Services (Provide description below)
Brief Description of In -Kind Payment:
Purpose: (Check one and provide description below) ❑Legislative ❑Governmental ❑x Charitable
Describe the legislative, governmental, charitable purpose, or event:
Sponsorship of 2019 Equality Awards
5. Amendment Description and/or Comments
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 3811"17�9 By
DATE - BIGNRTURE OF ELECTED OFFICER OR CPUC MEMBER
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)