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Home My WebLink About801 Form Parks & Rec - Big Bunny run and 4th of JulyPayment to Agency Report 1. Agency Name City of Cupertino Division, Department, or Region (if applicable) Parks and Recreation Street Address A Public Document 10300 Torre Ave., Cupertino CA 95014 Area Code/Phone Email Number 408-777-1312 laurens(aD_cupertino.gov Agency Contact (name and title) Lauren Sapudar, City Clerk 2. Donor Name and Address ❑ Individual Last Name First Name PAYMENT TO AGENCY REPORT Date Stamp • • CEIVED For Official Use Only AY 2 1 2026 CUPI RTINO CITY CLERK ❑ Amendment (explain in comment section) Date of Original Filing: (month, day, year) ❑Other Various Vendors Name Address City State Zip Code Parks and Recreation 2026 Sponsorship for Big Bunny Run and July 4th event and a donation. If "Other" is marked, describe the entity's business activity (if business) or its nature and interests. If applicable, identify the name of each source and the amount(s) received by the donor for this payment: (See attached itemized list) $ $ Name Amount Name Amount 3. Payment Information (Complete Sections 3.1 (a or b), 3.2, 3.3) 3.1 (a) Travel Payment Location of Travel Dates (month, day, year) ❑ Rail ❑ Air ❑ Bus ❑ Auto ❑ Other Transportation Provider Check Applicable Boxes Name of Lodging Facility $ $ Lodging Expenses Meal Expenses 3.1 (b) Payment(s) not related to travel: $ $ $ Transportation Expenses Other Expenses Total Expenses Dates (month, day, year) Total Expenses 3.2. Payment Description. Provide a specific description of the payment and its agency purpose and use. Parks and Recreation 2026 Sponsorship for Big Bunny Run and July 4th event and a donation. 3.3. Identify the officials who used the payment in Section 3.1 (See instructions) Last Name First Name Position/Title Department/Division Last Name First Name _ - Position/Title Department/Division 4. Verification I authorize a ceptance of the reported payment(s) as in compliance with FPPC regulations. c)-2_? / C Tina Kapoor Interim City Manager Signature Print Name Title (month, day, year) Comment: (Use this space or an attachment for any additional information) FPPC Form 801 (Jan/1 8) Form 801- 2026 Parks & Recreation Itemized List (Big Bunny Run & July 4th Sponsorship) Donated By Item Estimated Value Renewal by Andersen Monetary Donation $1000 Sponsorship: $400 for Big Bunny 5K Sponsorship & $600 4th of July Sponsorship Sponsor Email: fdamon@renewalbayarea.com Sponsor Phone Number: (510) 703-3319 Sponsor Address: 30806 Santana Street, Hayward, CA 94544 Kalos Health Monetary Donation $500 Sponsorship: $500 Big Bunny 5K Sponsorship Sponsor Email: Jennifer@livekalos.com Sponsor Phone Number: (415) 715-1285 Sponsor Address: 1875 S Bascom Ave, Campbell, CA 95008 Leadways School Monetary Donation $500 Sponsorship: $500 Big Bunny 5K Sponsorship Sponsor Email: georgia.m@leadways.school Sponsor Phone Number: (469) 954-7887 Sponsor Address: 20900 McClellan Rd, Cupertino, CA 95014 Sundar Krishnamurthy Donation $300 Donation: Eight Dumbbells Valued at $300 to Cupertino Sports Center Donor Email: sunkris@gmail.com Donor Phone Number: (408) 621-5572 Donor Address: 19963 Winter Lane, Saratoga, CA 95070