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CITY OF SANTA ANA
<br />PROPOSAL Add No. One
<br />PROJECT NO.: 18-2681
<br />CENTENNIAL LAKE CIRCULATION RENOVATION
<br />INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING
<br />ACTIVITIES
<br />This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of
<br />covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such
<br />payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a
<br />Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action.
<br />Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial
<br />filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional
<br />information.
<br />1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a
<br />covered Federal action.
<br />2. Identify the status of the covered Federal action.
<br />3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information
<br />previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by
<br />this reporting entity for this covered Federal action.
<br />4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the
<br />appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier
<br />of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,
<br />subgrants and contract awards under grants.
<br />5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the
<br />prime Federal recipient. Include Congressional District, if known.
<br />6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency
<br />name, if known. For example, Department of Transportation, United States Coast Guard.
<br />7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal
<br />Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.
<br />8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for
<br />Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the
<br />application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."
<br />9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of
<br />the award/loan commitments for the prime entity identified in item 4 or 5.
<br />10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to
<br />influenced the covered Federal action.
<br />(b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name,
<br />First Name and Middle Initial (MI).
<br />11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item
<br />10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material
<br />change report, enter the cumulative amount of payment made or planned to be made.
<br />12. Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and
<br />value of the in -kind payment.
<br />13. Check the appropriate box. Check all boxes that apply. If other, specify nature.
<br />14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the
<br />date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials.
<br />Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted.
<br />15. Check whether or not a continuation sheet(s) is attached.
<br />16. The certifying official shall sign and date the form, print his/her name title and telephone number.
<br />Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing
<br />instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
<br />information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
<br />reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.
<br />P-25 of P-25
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