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Behested Payment Report A Public Document <br />1. Elected Officer or CPUC Member (Last name, First name) <br />Giselle Hale <br />Agency Name NOV 1 8 2020 <br />Redwood City Council <br />Agency Street Address CITY OF REDWOOD CITY <br />CITY CLERK <br />1017 Middlefield Rd, Redwood City, CA <br />Designated Contact Person (Name and title, if different) <br />❑ Amendment (See Part 5) <br />Area Code/Phone Number E-mail (Optional) Date of Original Filing: _ <br />650-521-2134 ghale@redwoodity.org (month, day, year) <br />2. Payor Information (For additional payors, include an attachment with the names and addresses) <br />Community Foundation of San Carlos <br />Name <br />PO Box 113 San Carlos CA 94070 <br />Address City State Zip Code <br />3. Payee Information (For additional payees, include an attachment with the names and addresses.) <br />SMCU Community Fund (ATTN: Support Services) <br />Name <br />350 Convention Way Redwood City CA 94063 <br />Address City State Zip Code <br />4. Payment Information (Complete allinformation) <br />Date of Payment: 11/10/2020 Amount of Payment: (In-KindPMV) $ 10,000 <br />(month, day, year) (Round to whole dollars.) <br />Payment Type: ❑ Monetary Donation or ❑ In -Kind Goods or Services (Provide description below.) <br />Brief Description of In -Kind Payment: <br />Behested Payment Report <br />For Official Use Only <br />Purpose: (Check one and provide description below.) ❑ Legislative ❑ Governmental 9 Charitable <br />Describe the legislative, governmental, charitable purpose, or event: Donation to support childcare providers <br />impacted by Covid-19 in the City of San Carlos <br />5. Amendment Description and/or Comments <br />6. Verification <br />I certify, under penalty of perjury under the laws of the State of California, that to the best of my knowledge, the information contained <br />herein is true and complete. <br />Executed on 11115J2,&.1-0 <br />ATE <br />By <br />rid <br />SIGNATURE OF ELECTED OFFICER OR CPUC MEMBER <br />FPPC Form 803(January/201$) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3770 <br />