HomeMy WebLinkAboutAmy Chan - 4th Quarter - 08.01.2024City of Cupertino
Lobbyist
Total Numbe
including additio
CITY OF CUPERTINO
LOBBYIST REGISTRATION & REPORTING
CUPERTINO (CMCCH. 2.100)
TYPE OF REPORT (check all that apply)
❑ Initial Registration
0 Annual Renewal (filed annually by January 15)
Termination, effective date:
❑ Amendment, filed on date:
Amendment explanation:
Quarterly Report (CIVIC 2.100.100) (check one below)
❑ 1st quarter - January 1 to March 31(filed by April 15)
2nd Quarter - April 1 to June 30 (filed by July 15)
3rd Quarter - July 1 to September 30 (filed by October 15)
4th Quarter - October 1 to December 31(filed by January 15)
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LOBBYIST INFORMATION
Are ou a:
Contract Lobbyist
Business or Organization Lobbyist
❑ Expenditure Lobbyist
Note: Contract Lobbyist, Business or Organization Lobbyist, and Expenditure Lobbyist are defined in CIVIC
2.100.030(o).
Name of Lobbyist
Telephone Number
Business Address
(Number and Street)
City
State
Zip Code
Cupertino Business
License Number
City of Cupertino
Lobbyist Registration & Reporting
Page 2 of n
DB C �d 0
Federal Employer
Identification
Number (FEIN)�
Specify how the Contract Lobbyist, Business or Organization Lobbyist, or the Expenditure
Lobbyist entity is organized:
Sale Proprietorship
Partnership
❑ Non -Profit Corporation
{❑ For -Profit Corporation ,
❑ Other:
If the Lobbyist is a sole proprietor or partnership of fewer than ten (10) persons, state the
name(s) of the sots proprietor or pefSOns.With an ownership interest in the
a
business: C+CW
If the Lobbyist is a corporation (for -profit or non-profit), state the name(s) of corporate Officers
and the Agent for Service of Process and their respective contact information (if different from
above):
REPORT FOR EACH CATEGORY OF LOBBYIST
�t CONTRACT LOBBYIST (CIVIC 2.100 090(a)i
LIENT INFORMATIO"
Client Name,
Address, and
Telephone
Number
Effective Date of
Representation "S'
City of CuperUrw
Lobbyist Registration & Reporting
Page 3 of R
Specify the rsatare and pucpase of the ckent's business
Describe the legislative or administrative action(s) the Contract lobbyist was retained to
influence on behalf of the client. and the outcome sought (attach additional pages if
necessary).
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Name of each person wor!<tn or the Contract lobbyist I is engaged in lobbying activity
on be al of the client:
QA11—
ADDITIONAL CLIENTS
If the contract lobbyist represents more than one client, attach a separate page providing all of
the above information for each additional client.
0 BUSINESS OR ORGANIZATION LOBBYIST (CIVIC 2.1G0. Wt4j e
Name of Business
%ame of ownem, officers or emptoyees conducting lobbying activities on behalf of Business
or Organization:
Describe the nature and purpose of the business, organization, or association.
The legislative of administrative action`s) the business or organization fobbytst seeks to
influence
(Attach additional pages if necessary.)
City of Cupart na
Lobbpsl Registration & Remtng
?age 4 of 8
Name Of
Expenditure
Lobbyist
Name of each person working for the ExpencAture Cobby►st Char is engaged in ibbbying
activity (if applicable):
The legislative of administrative action(s) the expenditure lobbyist seeks to influence
Amount of Payment(s) ti r
Expenditure(s):
(CMC 2.100. 090fd))
Name of Payer /J/4111
(e.g. City agency, City Official
or City Official- elect, ballot
neasure committee)
,Name of Recipient Lobbyist
5
,y
Amount of Payments(s)
Date(s) of Payment(s)
CAMPAIGN CONTRIBUTIONS (CIVIC 2.100.i390)
Name of Lobbyist Making or
Delivering Contribution
Name of Contribution
Recipient (Officeholder,
Candidate, or Candidate -
Controlled Committee)
Date of Contribution
Amount of Contribution
S
Lost Reo*abon & Reporting
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Name of Lobbyist Making
Independent Expenditure
Name of City Official or
candidate for City office that
is intended benefidjry of
Independent Expenditure
Date of Expenditure
Amount or Expenaiture
(Attach a separate page providing ail of the above information for additional expenditures
as neededa
FUNDRAISING ACTIVITY (CMC j lh
Names) of beneficiary cif
Fundraising Activity (City
Official, candidate,
committee, or party)
Name of City Offtela=
requesting Fundraising
Activity (if applicable)
Date of Fundraking Activity
Name(s) of contributors who
made contributions in
Connection with Fundraising
Activity
Amounts) of contributions
raised in connection witn
Fundraising Activity
(east aseperate page Providing all of the above information for addMonai
needed.} expenditures as
DONATIONS TO ORGANIZATIONS MADE AT BENEST OF MY QFFICIAL OR (CANDIDATE CMC 2100 02 111
Recipient of Donation (for AA
profit or nonprofit
Organization)
Amount(s) of Danation(s) -
Date(s) of Donations
City of Cupertino
Lobbyist Registration & Reporting
Page 6 of 6
Note: only donations totaling more than $1000 in the aggregate per calendar year must be
disclosed.
CONTACTS WITH CITY OFFICIALS OR CITY OFFICIALS -ELECT (CMC 2.100.090(I))
Names) of City Officials) nr
City Officials) -Elect
contacted
Date(s) of Contact
Methods(s) of Contact
Approximate Number of Contacts during calendar year:
❑ One Contact
❑ Two to Five Contacts
Six to Ten Contacts
❑ Eleven or More Contacts
ACTIVITY EXPENSES (CIVIC 2.100.090(k))
Beneficiary or recipient(s) of
Activity Expense(s) (City
Official, City Official- elect or
member of his or her
immediate family or
domestic partner)
Amount(s) of Activity
Expense(s)
Date(s) of Activity
Expense(s)
Note: Activity Expenses include Gifts, honoraria, consulting fees, salaries and other forms of
Compensation, but do not include campaign contributions.
TERMINATION (2.100.060) V J
I certify that I have been authoriz d by the Lobbyist identified above to make this verification. I
have reviewed the requirements of the provisions of the Cupertino Municipal Code (Chapter
2.100). 1 certify under penalty of perjury under the laws of the State of California that I have
reviewed the Notice of Termination and to the best of my knowledge the information
contained herein is true and complete.
Termination Effective:
C#YOf*00
LobblOW RaO n & Reporting
Pap 7of8
�risg raizrda®
Title
Signature
Executed one
(month, day, year)
ATTACHMENTS lv�
I have reviewed the lobbyist audellnes and I have nothing to report.
Attached to this Report is/are the following:
(if additional space is needed, attach additional pages with responses to each of the
above disclosure categories)
FEES DUE (CIVIC 2.100.080 and see Fee Schedule A -- General)
Lobbyist Registration Fee* (January 1- December 31) $
Delinquent Fee $
Total Payment Due With Report $
Reglstratlert Fee
iDelinquerct Fees
$178.96
$25 per day with a
max of $500
Make checks payable to: City of Cupertino
Send Forma and Payment to: City of Cupertino
City Clerk's office
1030D Torre Avenue
Cupertino, CA 95014
NOTE: Late fees wN apply to any Lobbying "M*y not reported after the 15 days of qual►Jying as a W44st
*Initial registration free is dose within 15 days after qualifying as a lobbyist
VERIFICATION
I certify that ( have been authorized by the lobbyist identified above to make this Verification. I have reviewed the
requirements of the pravisIOns of the Cupertino Municipal Code (Chapter 2.100).1 certify under penalty of pet jury
under the (awe of the state of tahifornia that i have reviewed this Lobbyist Report and to the best of my knowledge
the information contained herein Is true and complete. (CIVIC 2.100.040(1))
Sprint Name
Title
Telephone Number
City of Cupertino
Lobbyist Registration & Reporting
Page 8 of 8
Signature
Executed on:
(month, day, year)
APPENDIX A:
Cupertino Municipal Code Ch. 2.100.
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