County ofsanta Clara Office ofthe Clerk ofthe Board ofsupervisors County Government Center, East Wing 70 West Redding Street San Jose, California 95110-1770 (408)299-5001 FAX 938-4525 Lynn Regadanz Clerk of the Board Page1 of 9 LOBBYIST DISCLOSURE REPORT Please 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 oflobbying 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: jkaune@nmgovlaw.com Business Address Street: 1600 Amphitheatre Parkway City: IVlountain View State: OA Zip Code: 94043 Mailing Address Street: do 2350 Kerner Blvd. Suite 250 City: San Rafael State: OA Zip Code: 94901 i I j 1;
COUNTY OF SANTA CLARA LOBBYIST DISCLOSURE REPORT Page 2 of 9 LOBBYIST GONTACT SHEET Date(s) of Contact:_ Date(s) of Contact:_ Contacts.(1) (2-5).(6-10) Date(s) ofcontact:_ Date(s) of Contact:_ Date(s) ofcontact:_ Date(s) ofcontact:_ This page may be duplicated. Check the box if this jjage is:cluplicated. i ' S
COUNTY OF SANTA CLARA LOBBYIST DISCLOSURE REPORT Page 3 of 9 ipescribe the organization of the Lobbyist (i.e. soleproprietorship, partnership, corporation, etc.): ;Corporation Ifthe Lobbyist is a sole proprietorship or partnership offewer than five people, list the names ofall owners. 1. 2. :4. 5. Ifthe Lobbyist is a corporation, list the names of the officers and agent for services of process. :^1. Larry Page 2. Eric E. Schmidt 3. Sergey Brin n Nikesh Arora David C. Drummond 6. Patrick Pitchette i:7. 8. 9. vlo. 11. Agent: Qgc - Lawyers Inc Ser The remainder ofthe Lobbyist Disclosure Report is divided into 4 sections. Contract Lobbyists must complete Sections la, IB, and IC. In-House Lobbyists must complete Section II. Expenditure Lobbyists must complete Section III. All Lobbyists must complete Section IV, Fees and Verification. ^
; SECTION la. CONTRACT LOBBYIST INFORMATION Page 4 of 9 \ Contract Lobbyists must complete the followins forms: IA: Contract Lobbyist Information (This Form) IB: Current and Former Client List IC: Current Client Disclosures ; vt J ^ OF THE BUSINESS GANigtlbK^ i"..v Describe the purpose ofthe Contract Lobbyist's business. : EMPLOYEES ENGAGED IN LOBBY ACTIVITY Ifthe Contract Lobbyist is an entity, name ofeach person working for the Contract Lobbyist who contacts -County Officials on behalfofthe lobbyist, and list his or her clients. ; Lobbyist Client(s) 1. 2. 3, 4. 5. 6. 7. 8. 9. 10.
SECTION IB. CONTRACT LOBBYIST INFORMATION Page 5 of9 CURRENT AND FORMER CLIENT LIST : )..'i Client Name Effective Date Client Name Termination Date :itliispage may be duplicated. Check the box if this page is duplicated.
SECTION IC. CONTRACT LOBBYIST INFORMATION Page 6 of9 CLIENT INFORMATION Contract Lobbyists must complete thisform for all current clients.. Current Client Information: Name: Email: Telephone: Fax: It ii ^3 Business Address Street: City: State: Describe the nature and purpose ofthe Client's business. Zip Code: ''li i5 n i i li "I LEGISLATIVE OR ADMINISTRATIVE ACTION(S) LOBBYIST SEEKS TO INFLUENCE I I Describe indetail the legislative oradministrative action(s) the Contract Lobbyist was retained to influence and the outcome sought. L. 2., 3._ 4. COMPENSATION The total compensation promised or received from the Client for lobbyist services: if a $0.00 - $500 $501 -$1,000 $1,001 -$10,000 $10,001 -$100,000 $100 001 -$200,000 $200,001 - $300,000 $300,001 -$400,000 This page may be duplicated. Check the box ifthis page is duplicated. Ove $400,001 'i ij
SECTION II. IN-HOUSE LOBBYIST Page7 of 9 EMPLOYEES ENGAGED IN LOBBY ACTIVITY j: Name of each owner, compensated officer, or compensated employee engaged in lobbying activity on behalfofthe In-House Lobbyist: ij 1. Nealesh Patel 2. Davis White 3. Gilbert Gallardo n 4. Taj Wilson 5. John Toccalino 6. Michelle Olsen 7. Curtis Heley 8. jenn Chang 9. i! 10. 11. 12. ' THE PURPOSEOF THE IN-HOUSE LOBBYIST ENTITY - :idescribe the nature and purpose ofthe In-House Lobbyist's business. i Provides internet related services LEGISLATIVE OR ADMINISTRATIVE ACTION(S) LOBBYIST SEEKS TO INFLUENCE fi Describe in detail the legislative or administrative action(s) the In-House Lobbyist seeks to influence and the Voutcome sought. ji Google Fiber expansion to the region (https;//fiber.google.com/newcitjes/) ' -il 'i i I i << I II. 1. 'I
SECTION III. EXPENDITURE LOBBYIST Page 8 of9 ' ^ - Vemployeesengaged^m -. Name ofeach person working for the Expenditure Lobbyist that is engaged in lobbying activity: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Amount ofexpenditure: $_ THE Ppia>OSE OFTHEBUSINESSrORGAMZATIONORASSOCIATIC^ Describe the purpose ofthe Expenditure Lobbyist's business. i;. ^LEGISLATIVE OR ADMINISTI^TIVE;ACTION(S) LOBBYIST SEEKS TO INFLUENCE Describe in detail the legislative or administrative action(s) the Expenditure Lobbyist seeks to influence and ' = the outcome sought.. i
SECTION IV. FEES AND VERIFICATION Page 9 of9 FEES DUE Initial Registration Fee - $180 '100 00 (filed between January 1-June 29 for period ending December 31) ^ IOU. UU 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 ofregistration - $60 per calendar day Penalty for Delinquent Filing of Quarterly Disclosure Report - $10 Total Payment Due with Report $ $ $ 3 180.00 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 a Quarterly Lobbyist Disclosure Report due on the 15th ofeach month following the calendar quarter. I acknowledge that a late 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 of perjury under the laws of the State of Califor nia that I have reviewed this Lobbyist Report and to the best of my knowledge the information contained herein is true, correct, and complete. PrimName J^SOn D. KaUHe Attorney &Agent Signature Date