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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6903 <br />HAZARD AVENUE PROTECTED BIKE LANES <br />FEDERAL PROJECT NO: CML-5063 (182) <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />DISCLOSURE OF LOBBYING ACTIVITIES Apploredby ONa <br />Complete this form to disclose lobbying activities pursuant to 31 U.S.G. 1352 034510W <br />Mee reverse for cublic burden disclosure-1 <br />C Type of Federal Action_ <br />2. Status of Federal Action: <br />3. Report Type - <br />Fa a_ contract <br />®a. bidlotferlapplication <br />®a. initial filing <br />b_ grant <br />b. initial award <br />b. material change <br />c. cooperative agreement <br />c. post -award <br />For Material Change Only: <br />d. loan <br />year quarter <br />e. ban guarantee <br />dare of last report <br />f, loan insurance <br />4_ Name and Address of Reporting Entity: <br />5. N Reporting Entily in No. 4 is a Subawardee, Enter Name <br />EI prate ❑ swswaruea <br />and Address of Prime: <br />Tier , ifknown: <br />N/A <br />Congressional District, if known: <br />Congressional District, if krlO <br />6. Federal DepartmenflAgency: <br />7. Federal Program NamelDescription: <br />N/A <br />N/A <br />CFDA Number, if applicable: <br />S_ Federal Action Number, if known: N/A <br />9. Award Amount, if known: N/A <br />$ <br />10. a_ Name and Address of Lobbying Enffty b. Individuals Perforating Services (including address if <br />(if individual• last name• fast name, ml): different from No. 10a) <br />(last name, fast name, Ml): <br />N/A N/A <br />'�CarA Canaa luamn a SF4I" j"Rassfillm <br />1 t. Amount of Payment (check all that apply): <br />13. Type of Payment (check all Mat apply): <br />s N/A ❑ actual ❑ w—1 <br />❑ a ratatner <br />N/A <br />12. Font of Payment I check aA that apply} <br />❑ C. clNm Wca <br />❑ a ca m N/A <br />Elon d cltngaut I- <br />❑ 0.1M1IINt: apedry: nature <br />❑ c. tladarretl <br />value <br />❑ T. other: specry: <br />14. Brief Description of Services Performed or to be Performed and Datefs) of Service, including otbcer(s), <br />employeefs), or Member(s) contacted, for Payment Indicated in Item 11: <br />N/A <br />amm conll s X <br />15. Continuation SheetIs I IND <br />16_ "e�"'a�° say. r ram r .maea he m s u ac ..s <br />hMT. Yip ama. d BbrNg dYap 6 . e1�Y � M f"t <br />Signature: <br />Print Name: Abraham Jeon <br />Title: President <br />wanr.n r h.,.ate"r c.p�...w.ry r r err P <br />Telephone No_ 714-523-2372 <br />Date:2 26 202 <br />Federal Use Only: <br />AullccUacW lava RepoaMal, <br />sweat/ Farm uu- Pt . 7 <br />W: <br />, USMA <br />