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Behested Payment Report A Public Document <br />1. Elected Officer or CPUC Member (Last name, First name) Date Stam <br />Giselle Hale E C E$ V E <br />Agency Name <br />Redwood City Council NOV 1 8 2020 <br />Agency Street Address <br />CITY OFREDWOOD <br />CLV�RKO CI <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 ghale9redwood ity.org <br />2. Payor Information (For additional payors, include an attachment with the names and addresses.) <br />Chan Zuckerberg Initiative <br />Name <br />601 Marshall St Redwood City CA <br />Address <br />City <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 <br />Address <br />Redwood City <br />City <br />State <br />CA <br />State <br />Behested Payment Report <br />For Official Use Only <br />(month, day, year) <br />94063 <br />Zip Code <br />94063 <br />Zip Code <br />4. Payment Information (Complete allintormatlon) <br />Date of Payment: 11110/2020 Amount of Payment: (In-KindFMV) $ 200000 <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 />Purpose: (Check one and provide description below.) ❑ Legislative ❑ Governmental 0 Charitable <br />Describe the legislative, governmental, charitable purpose, or event: Donation to support childcare providers <br />impacted by Covid-19 in San Mateo County <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 />4 <br />Executed on ! i ISS 20?10 By Q_FdqW4a'zL Ye�L_&. <br />DATT SIGNATURE OF EL ED OFFICER OR CPUC MEMBER <br />FPPC Form 803 (January/2018,) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3773) <br />