803 Geoff Kors 2019-19-19 Desert Regional Medical CenterBehested Payment Report A Public DPp¢t OWU Behested Payment Report
1. Elected Officer or CPUC Member (cast name, First name)
ate tamp
Kors, Geoff
PM 2 37
a
For Official Use Only
Agency Name
Palm Sprngs City Council 'OFFICE OF THE
CITY CLEF::.
Agency Street Address
3200 E. Tahquitz Canyon Way
Designated Contact Person (Name and title, if different)
❑ Amendment (See Part S)
Date of original Filing:
Area Code/Phone Number
E-mail (optional)
monm, day year)
7605370061
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
Desert Regional Medical Center
1150 North Indian Canyon Drive
Palm Springs
CA 92262
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
4. Payment Information (Complete all information.)
Los Angeles
CA 90010
State Zip Code
Date of Payment: 08/16/19 Amount of Payment: (m-KindFMV) $ 10,000
(month, day, year) (Round to whole dollars.)
Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services(P,dwde descnpoon below.)
Brief Description of In -Kind Payment:
Purpose: (Check one and pmWde description below.) ❑ Legislative ❑ Governmental 0 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 09/08/19 By'�
DATE iG ATURE EtFC OOEFICE OR CPUCMEMEER
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (966/275-3772)