ATTACHMENT B
Public Integrity Disclosure
CITY OF PALM SPRINGS – PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
(Revised 09 13 18)
PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
1. Name of Entity
2. Address of Entity (Principle Place of Business)
3. Local or California Address (if different than #2)
4. State where Entity is Registered with Secretary of State
If other than California, is the Entity also registered in California? Yes No
5. Type of Entity
Corporation Limited Liability Company Partnership Trust Other (please specify)
6. Officers, Directors, Members, Managers , Trustees, Other Fiduc iaries (please specify) Note: If any response is not a natural person, please identify all officers, directors, members, managers and other fiduciaries for the member, manager, trust or other entity
_________________________________________________ Officer Director Member Manager [name]
General Partner Limited Partner
Other ____________________________________
_________________________________________________ Officer Director Member Manager [name]
General Partner Limited Partner
Other ____________________________________
_________________________________________________ Officer Director Member Manager [name]
General Partner Limited Partner
Other ____________________________________
Brightly Software, Inc.
4242 Six Forks Rd, Ste 1400, Raleigh, NC 27609
Delaware
n/a
Donald Kurelich
Saanchika Weerasinghe
Kelly Caputo
See attached page for additional Officer
Docusign Envelope ID: 2E5A5C82-E373-4AF3-A2C2-ACA80D60743B
CITY OF PALM SPRINGS – PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
(Revised 09 13 18)
7. Owners/Investors with a 5% beneficial interest in the Applicant Entity or a related entity
EXAMPLE
JANE DOE
[name of owner/investor]
50%, ABC COMPANY, Inc.
[percentage of beneficial interest in entity
and name of entity]
A.
[name of owner/investor]
[percentage of beneficial interest in
entity
and name of entity]
B.
[name of owner/investor]
[percentage of beneficial interest in
entity
and name of entity]
C.
[name of owner/investor]
[percentage of beneficial interest in
entity
and name of entity]
D.
[name of owner/investor]
[percentage of beneficial interest in
entity
and name of entity]
E.
[name of owner/investor]
[percentage of beneficial interest in entity
and name of entity]
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT.
Signature of Disclosing Party, Printed Name, Title
Date
Siemens Corp
100%
Docusign Envelope ID: 2E5A5C82-E373-4AF3-A2C2-ACA80D60743B 28 January 2026
Secretary and General CounselKelly Caputo
City of Palm Springs
Public Integrity Disclosure
6. Officers, Directors, Members, Managers, Trustees, Other Fiduciaries, contd.
Randi Rosenberg Officer
Docusign Envelope ID: 2E5A5C82-E373-4AF3-A2C2-ACA80D60743B