County ofsanta Clara Office of the Clerk of the Board of Supervisors County Government Center, East Wing 70 West Hedding Street San Jose, California 95110-1770 (408) 299-5001 FAX 938-4525 Lynn Regadanz Clerk of the Board Page 1 of 9 LOBBYIST DISCLOSURE REPORT piepse mark the type of report being filed: Initial Registration / Annual Registration and Quarterly Lobbyist Disclosure Report for Oct. 1 - Dec. 31 (Due Jan. 15) Quarterly Lobbyist Disclosure Report for Jan. 1 - Mar. 31 (Due Apr. 15th) Quarterly Lobbyist Disclosure Report for Apr. 1 - Jun. 30 (Due Jul. 15th) Quarterly Lobbyist Disclosure Report for Jul. 1 - Sept. 30 (Due Oct. 15th) Amendment to Disclosure Filed: Termination of Lobbying Activity (A lobbyist termination sheet must also be completed) Report each category of lobbyist: (Check all that apply) / Contract Lobbyist In-House Lobbyist Expenditure Lobbyist Lobbyist Information: Name: Google Fiber Inc. Telephone: 415-389-6800 Fax: 415-388-6874 Email: elama@nmgovlaw.com Business Address Street: 1600 Amphitheatre Parkway City: Mountain View State: OA Zip Code: 94043 Mailing Address Street: c/o 2350 Kerner Blvd., Suite 250 City: San Rafael State: OA Zip Code: 94901
COUNTY OF SANTA CLARA LOBBYIST DISCLOSURE REPORT Page 2 of 9 LOBBYIST CONTACT SHEET Date(s) of Contact:_ Contacts.(1).(2-5).(6-10) Date(s) of Contact:_ Contacts.(1).(2-5).(6-10) Date(s) ofcontact:_ Contacts.(1).(2-5).(6-10) Date(s) of Contact:_ Contacts.(1).(2-5).(6-10) Date(s) of Contact:_ Contacts.(1) (2-5).(6-10) Date(s) ofcontact:_ Contacts.(1).(2-5) (6-10) This page may be duplicated. Check the box if this page is duplicated. O
COUNTY OF SANTA CLARA LOBBYIST DISCLOSURE REPORT Page 3 of9 ; Describe the organization of the Lobbyist (i.e. sole proprietorship, partnership, corporation, etc.) Corporation 'i ri Ifthe Lobbyist is a sole proprietorship or partnership offewer than five people, list the names ofall owners. Sf 1. None this Quarter 4. 2. 5. ^5 Ifthe Lobbyist is a corporation, list the names ofthe officers and agent for services ofprocess. *1. Larry Page 2. Eric E. Schmidt 3. Sergey Brin <1 ;4. David C. Drummond 5. Omid Kordestani Ruth M. Porat ;:7. 8. 9. :10. 11. Agent; q3q Lawyers Inc The remainder ofthe Lobbyist Disclosure Report is divided into 4 sections. Contract Lobbyists must complete Sections la, IB, and IC.?! n 'i i In-House Lobbyists must complete Section II. Expenditure Lobbyists must complete Section III. All Lobbyists must complete Section IV, Fees and Verification.
SECTION I A. CONTRACT LOBBYIST INFORMATION Page 4 of 9 ;/ Contract Lobbyists must complete the followins forms: la: Contract Lobbyist Information (This Form), IB: Currerit and Former Client List '., IC: Current Client Disclosures. THE NATMppF THE&SINESS, ORGANIZATION OR ASSOCIATION Describe the purpose ofthe Contract Lobbyist's business. EMPLOYEES ENGAGED IN LOBBY ACTIVITY ilfthe Contract Lobbyist is an entity, name ofeach person working for the Contract Lobbyist who contacts. Jj JCounty Officials onbehalf of the lobbyist, and list his or herclients. ;;5 Lobbyist Client(s) H 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
- SECTION IB. CONTRACT LOBBYIST INFORMATION Page 5 of 9 ff CURRENT AND FORMER CLIENT LIST LIST ALL CURRENT CLIENTS Client Name Effective Date ;LIST ALL CLIENTS TERMINATED DURING THE PREVIOUS QUARTER iclient Name ; ^ -j Termination Date i j! 1 1 i i, 1 ; i ;,Thispage'may He duplicated. Check the trax if this page is duplicated. Updated.3/2014 ITl! i
SECTION IC. CONTRACT LOBBYIST INFORMATION Page 6 of 9 CLIENT INFORMATION \ Contract Lobbyists must complete thisforth for all current clientsj:! '! Current Client Information: Name; Telephone: Fax: Email: Business Address p Street: ; City: State: Zip Code:. Describe the nature and purpose of the Client's business. ' t \. LEGISLATIVE OR ADMINISTRATIVE ACTION(S) LOBBYIST SEEKS TO INFLUENCE Describe in detail the legislative or administrative action(s) the Contract Lobbyist was retained to influence and the outcome sought. L. i i' 2._ 3-_ J' 4. COMPENSATION, Thetotal compensation promised or received from the Client for lobbyist services: $0.00-$500 $501 -$L000 $1,001 -$10,000 $10,001 -$100,000 $100,001 -$200,000 $200,001 -$300,000 $300,001 -$400,000 Over $400,001 This page may be duplicated. Check the box if this page is duplicated.
SECTION 11. IN-HOUSE LOBBYIST Page 7 of 9 EMPLOYEES ENGAGED IN LOBBY ACTIVITY-,. - I Name ofeach owner, compensated officer, orcompensated employee engaged inlobbying activity on be- J half of the In-House Lobbyist: 1. None this Quarter 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. THE,PURPOSE OF THE IN^HOUSE LQpm^ ENTITY Describe the nature and purpose ofthe In-House Lobbyist's business. Provides internet related services '; ; legislative OR administrativeaction(s) LOBBYIST SEEKS TO INFLUENCE '.;, i Describe in detail the legislative or administrative action(s) the In-House Lobbyist seeks to influence and the outcome sought. 1 i ; Google Fiber expansion to the region (https://fiber.google.com/newcities/) if i'j. 1 ". h i
SECTION III. EXPENDITURE LOBBYIST Page 8of9 [ EMPLOYEES ENGAGED IN LOBBY ACTIVITY Name of each person workingfor the Expenditure Lobbyist that is engaged in lobbying activity: : 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Amount ofexpenditure; $_ THE PURPOSE OF THE BUSINESS, prgamzation OR ASSOCIATION Describe the purpose ofthe Expenditure Lobbyist's business. 'J )i I LEGISLATIVE OR ADMINISTRATIVE ACTION(S) LOBBYIST SEEKS TO INFLUENCE.I" Describe in detail the legislative or administrative action(s) the Expenditure Lobbyist seeks to influence and the outcome sought.
SECTION IV. FEES AND VERIFICATION Page 9 of 9 FEES DUE Initial Registration Fee - $180 (filed between January 1 - June 29 for period ending December 31) Reduced Registration Fee - $90 (filed between June 30 - December 31 for period ending December 31) Annual Registration Fee - $60 (due by January 15th) Penalty for Delinquent Filing of Registration - $60 per calendar day Penalty for Delinquent Filing of Quarterly Disclosure Report - $10 Total Payment Due with Report J $, $ $ $ VERIFICATION (Check all verifications) / I acknowledge that each Lobbyist is required to file an Annual Registration Report and pay annual fees due on the 15th ofjanuary. >/ I acknowledge that each Lobbyist is required to file aquarterly Lobbyist Disclosure Report due on the 15th of each month following the calendar quarter. jz I acknowledge that alate fee will be assessed for late annual and quarterly reports. I certify that I have been authorized by the Lobbyist(s) identified above to make this verification. I have reviewed the requirements ofthe provisions ofthe County of Santa Clara Ordinance Code Division A3, Chapter VII, relating to Lobbying. I certify under penalty ofperjury under the laws ofthe State of Califor nia that I have reviewed this Lobbyist Report and to the best ofmy knowledge the information contained herein is true, correct, and complete. D-,., Erin Lama Attorney&Agentforpner Print Name Title Signature Date