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CITY OF SANTA ANA RE -BID <br />PROPOSAL <br />PROJECT NO.: 17-6876 <br />CROSSWALK UPGRADES PHASE, II <br />FEDERAL PROJECT NO: HSIPL 5063(186) <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />DISCLOSURE OF LOBBYING ACTIVITIES Ndafo� <br />Complete this term m disdw�e lobbying activities pursuant to 31 t1.SC. 1352 alaaaews <br />See reve fo ubbt burden disclosure. <br />Type of Federal Action: <br />2. Status of Federal Action: <br />M. Report Type: <br />a_ codract <br />�a_ bidaRerlapplieation <br />a. intial filing <br />. grant <br />b_ initial award <br />b. material change <br />C. five a irrament <br />m post -award <br />For Material Change Only: <br />d_ <br />year quenar <br />e_ loan grantee <br />dab of last report <br />f. ban i nce <br />a. Name arid Add s of Reporting Entity_ <br />5. h Reporting Entity in No. a Is a Subawardee Name <br />❑ Pam tmwmWa <br />and Address of Prime: <br />ifkrown: <br />sforal Distdet. WAIM0wn: <br />Cm a,".nal District. vf* n: <br />6 Federal Dept, tar NAgency: <br />7. Federal Prograwr Name/ cription' <br />CFOA Number, ffa e: <br />8_ Federal ction Number, dtrowr- <br />A <br />A. d 14nou. , fitnarn <br />f0_ a_ Name and Address of Lobbying Entity b.1 Perfrrnni)g Services (a akiding address A <br />(ifindividual. Last name, fast nime. un: dam Not lam) <br />tLa namfirst name. All} <br />outdo i vrarnoma i sff-ltca r <br />11_ Asmara of Payment (check air Oat amply): <br />13- Type of Payment ( all Nat apply): <br />❑achai ❑ <br />❑anwner <br />❑ bamisla <br />❑ C. toonsaw an <br />12. Form of Payment (check a0 Nat apply . <br />❑ a con <br />Ela emlagntwe <br />❑ 0.tlktlwspadaj: nature <br />❑ a eafwtad <br />value <br />❑ I. abet spec y: <br />14. Brief Desorption of Seryj&s Performed or to he Fedenned and Datetsl of Service, Including m1g ris}, <br />employeels), or Meml sl contacted, for Payment Indicated in hem 11: <br />Slatrl 1':trB a SFI.I[�1 f <br />15. Conlin Shoes SF-LLLA attached: Via <br />i6.'""Y°°' •sv. ar r-m . nn+xw 4 r n LL aC r.a, <br />Signature'. <br />Print NameO DQ <br />dle: <br />Vite dents <br />570 <br />21512020T <br />oNo-- Door - <br />Federal Use Only: <br />lu.uraxawr tacat nNnevtcOM <br />3bnvbnd Fam DL tiev.7 7 <br />NXP 6 RE -BID <br />