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CITY OF SANTA ANA <br />PROJECT NO. 1.3-6786 <br />PROPOSAL AND CONTRACT AGREEMENT <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />Comnlefe this form to disclnse lnhhvinv activifies rorcsjiant to 31 TT C C 1359 <br />1. Type of Federal Action 2. Status of Federal Action 3. Report Type: <br />® a Contract ® a.. Bid/offer/application ® a. initial <br />b. Gant b. initial award b. material change <br />c. Corporate Agreement c, post-award <br />d Ban For Material Change only: <br />e. Loan Guarantee Year quarter <br />f Loan Insurance date of last report <br />4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and. <br /> Address ofPrime: <br />® Prime ? Subwardee N/A <br />Tier. If hmivn <br />Congressional District, f knoww Co ional District, f known <br />6. Federal Department/Agency: 7. Federal Program Name0escription <br />N/A N/A <br /> CFDA Number, If applicable <br />8. Federal Action Number, if known 9. Award Amount, f known <br /> <br />10. a. Name and Address ofLobbying Entity b. Individual Performing Services (irhLk a"-e sff YfromA7o. <br />pd Iadnw l Av IGb) <br /> <br />None None <br />(attach Continuation Sheets if necessary) <br />11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply) <br />$ None ? Actual ? Planned ? a. retainer <br /> ? b. onefiime fee <br />12. Form ofPayment (check all that apply): ? c. commission <br />? a. cash ? d. contingent fee <br />? b. in-Bond; specify: nature ? e. deferred <br />value ® f. other, specify__ <br />14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for <br />Payment indicated in item 11: <br />Hardy & Harper has not paid funds to anyone in regards to this project. <br />(affach Conf mtwion Sheet( s) nwesscn <br />15. Continuation Sheets attached: ? Yes <br />16.lnfrArafimm ie,sfedthtougbftfcansa&aizodbyTitle3lUSCSittig <br />13521hisdisclosumoflobbyingackvifmisarnWzidrelxti imoffidupm Signature <br />whirhmbmxwaspboedbythetierabuwwbm #i,-twsawmwas nr&crataed %LOOW <br />info.Th's&doRnismTzedpimmtto3lU.S_C1352T1isinbrnatunwme Print Name Steve Kirschner <br />rTortedtotheCan_msssm i-auvrallyandvabewallablefxpMci gvcdan. <br />Anypmanwhofitlstofilethem4xeddisdm=sbObesubjed.baadpamltyof Title Vice President <br />rrot less than $10,000 and nd mae than. $100,000 far each such faflure <br /> Tel hone No. 714 - 4 4 4 -18 51 Date 1/8/13 <br />Feda=WseOnly <br />I <br />AubxLwd for Local RqxWucton <br /> standardnoRil-LLL <br />TO BE INCLUDED IN BID PACKAGE <br />BP 15 of 15