Giselle Hale Form 803s 11-18-2020

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Behested Payment Report A Public Document 1. Elected Officer or CPUC Member (Last name, First name) Giselle Hale I r)lD E Agency Name NOV 1 S Redwood City Council IN Agency Street Address CITY OF H 130 1017 Middlefield Rd, Redwood City elcE l Designated Contact Person (Name and title if different) Behested Payment Report •`0 L CITY Use Only ❑ Amendment (See Part 5) Area Code/Phone Number E-mail (Optional) Date of Original Filing: 650-521-2134 ghale@redwoodcity.org (month, day, year) 2. Payor Information (For additional payors, include an attachment with the names and addresses ) Community Foundation of San Carlos Name PO Box 113 San Carlos CA 94070 Address City State Zip Code 3. Payee Information (For additional payees, include an attachment with the names and addresses.) Community Equity Collaborative Name PO Box 7062 Menlo Park CA 94026 Address City State Zip Code 4. Payment Information (Complete all information.) Date of Payment: 11/10/2020 Amount of Payment: (In-KindFMV) $ 10,000 (month, day, year) (Round to whole dollars) Payment Type: ❑ 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 ❑ Charitable Describe the legislative, governmental, charitable purpose, or event: Donation to support childcare providers impacted by Covid-19 in the City of San Carlos 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 �- r� °_ By SIGNATURE OF ELECTED OFFICER OR CPUC MEMBER FPPC Form 803 (January/2018) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-377x)