Document 76 - Attachment 1
Event Information Request Form
Thank you for your interest in hosting the U.S. Secretary of Energy at your event. To ensure that the appropriate individual within the Department ofEnergy is participating in your event and because the Office of the Secretary is committed to maintaining the highest ethical standards, we need the information requested below before we can agree to confirm a speaker.
Please respond to the questions below and send your response to the.secretary@hg.doe.gov. If you have any questions you may contact the Secretary's Scheduling Office at 202-586-5534.
Title of the Event (please note if the event is a weekly, monthly, annual, etc.):
Carbon Innovation Forum (annual)
Date of Event (please note if the date is flexible): September 22, 2025
Event Location (venue, address, city and state/country) :
SECOND 849 6th Ave, New York, NY 10001 , USA
Point(s) of Contact (Name, Email, Phone):
Briefly describe the event in detail including the purpose and desired role of the Secretary (i.e. deliver keynote remarks, attend an event, meet with attendees etc.):
Emily Johnson, emily@ciearpath.org,(b) (6) Chris Tomassi, tomassica2clearnatb.or1r, (b) (6)
The Forum will cover exciting developments in American-made, low-carbon technology; explore ways to remove um1ecessary regulatory baiTiers; and critically examine the investments needed to scale up the energy technologies required to bolster U.S. geopolitical strength.
We are inviting the Secretary to participate in a 20minute fireside chat with the C learPath CEO.
There is also a VIP lunch directly before the fireside chat from 12:00pm - 1:00pm at the same location, which the Secretary would be welcome to attend.
Is the event a fundraiser? If yes, please explain who it is benefiting (i.e. specific charity, a political candidate, etc.): Audience Approximately how many people are expected to attend the event?
No 250-300 people
Please describe the target audience of the event (elected officials, local community leaders,
Senior government officials, energy executives, project developers, technology sta1tups, investors and thought leaders
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academics, industry representatives, public sector representatives, etc.).
Will the attendees at the event include persons with a diversity of views or interests, or representatives from throughout an industry or profession, or the range of persons interested in a matter? (If yes, please describe.)
Yes, there will be a diversity of views represented from the energy and financial services industries.
Is the event open to the public (this includes ticketed individuals)? If not, please describe who is privately invited.
No, this event is by invitation-only and sect11ity will be on-site. A full invitation and RSVP list can be provided.
Who are other VIPs or speakers confirmed and in what role?
We are in the early stages of extending invitations.
Who are other VIPs or speakers invited?
Remarks If you are requesting remarks, are there any specific issues you would like the Secretary to highlight/address in his remarks?
Secretary Burgum was invited to give keynote remarks at the aforementioned VIP lunch.
Energy innovation, energy dominance
What is the desired fom1at of his remarks (wi ll he be delivering the keynote, sharing the stage, participating in a panel or roundtable, etc.)?
Fireside chat. Questions will be provided in advance in collaboration with the Secretary's team.
What is the public registration/ticket fee to
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attend/participate in the event?
Will there be a teleprompter available? Will there be a podium?
Communications/Press Is the event open or closed to press?
No teleprompter Yes, podium, but the Secretary would be seated in a chair.
Closed to press but subject to change.
If open, are you expecting local, state, or national NIA
news coverage?
If this is an annual event, which news outlets
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typically cover the event?
Will you be advertising or live streaming the event No on any social media outlets or websites? (If yes, please explain.)
Lot?:istics/Other*
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If this invitation includes any gifts to the Secretary (e.g., waived registration/conference event fee; meals or refreshments; receptions or other entertainment; informational materials; award; transportation; memento or token ofappreciation), please identify them and provide their monetary value. Please also identify how the value was determined. (Please attach separate sheet if necessary.)
If the Secretary accepts our invitation to attend the VIP lunch, that meal would be provided. Previous DOE participants have reimbursed ClearPath for the cost of their meal. Lunch would total around $30 per meal per person.
Does the invitation extend to the Secretary's spouse or other guest? If yes, will others in attendance generally be accompanied by a spouse or other guest?
Will the Secretary be asked to sign a speaking/participation agreement or release related to this event? If so, please provide a copy. If the Secretary is not able to attend, is a surrogate desired? If yes, anyone specific?
Any additional notes or infonnation?
Secretary Wright is welcome to extend the invitation to his team.
No -
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Yes, Dario Gil
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Event Host and Sponsor Who is the event host? (Please identify and provide background on the Event host as well as any other organization involved in the Event.)
ClearPath and the American Petroleum Institute (A.PI) are the event co-hosts.
ClearPath (501(c)(3)) is a nonprofit that collaborates with public and private sector stakeholders on innovations in nuclear energy, carbon capture, hydropower, natural gas, geothem1al, energy storage, and clean manufacturing to enable private-sector deployment of critical technologies.
Event host website/url. Is the event host a registered lobbyist or lobbying organization, and/or registered under the Foreign Agents Registration Act? (If yes, please identify.)
A.PI represents all segments of America's natural gas and oil industry. API's mission is to promote safety across the industry globally and to influence public policy in support of a strong, viable U.S. oil and natural gas industrv. httos://clea.rpath.org/the-carbon-innovation-fornm/ No
Is the event host a partisan political candidate, a No
representative ofa political party or a registered political action committee (PAC)? (If yes, please identifv.)
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Is the event host a 501(c)(3) organization or a media organization? (If yes, please identify.)
Yes, ClearPath is a 501(c)(3) nonprofit organization
Is the event host seeking or currently have any
No
business interests with the Department such as
permits, contracts, litigation, grants, etc.? (If yes,
please describe.)
Who are the sponsors ofthe event? Please identify and provide background information on the individual and/or entity.
ClearPath and API are the hosts and sponsors.
Are any event sponsors seeking or do they
No
currently have any business interests with the
Department such as permits, contracts, litigation,
grants, etc.? (Ifyes, please describe.)
.
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With which Bureau or Agency does your agenda most align? Please list all, if more than one.
DOE, DOI, PHMSA
Partisan Political Candidate or Elected Official Participation
--
Will any partisan political candidate or elected
No
official participate in the event? If so, please
identify and explain role.
Is the coordination ofany elected official's
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involvement being handled solely by their official
staff, or is there any campaign staff involvement or coordination?
If a candidate for office or elected official is
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participating in the event, is the event taking place
in their respective district/jurisdiction, and will the
entire delegation for the respective
district/jurisdiction(s) been invited? If not, please
explain.
lit to the ethics analysis and is 1101 a
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