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CITY OF SANTA ANA <br />Project No. 11-2606: Fisher Park Butterfly and Bird Habitat <br />Project No. 13 -7515: Centennial Park Slope Repair <br />PROPOSAL AND CON'rRACT AGREEMENI <br />DISCLOSURE OF LOBBY1NQACLT1V1T1FS <br />Complete this fibmi to disclose lobbV in activities ursuant to 31 U,&C 1352 <br />L'Fypa of Federal Action 2. Status of Federal Action 3. RepriftType: <br />❑ a. Coridact ❑ a, Bidoilbr/applEatiott ❑ a. initial <br />b. Grant K initial award b. material chratri a <br />c. Corporate Agreement c, post-toyad <br />d. Ban Per- Material Change only: <br />' Change only: <br />e. Lomo, Guarantee —Rer <br />C Loan firsnumice I 1d: ctTCIlait i'�2 1 <br />4. Name and Address of Reporting Ew@T— 5. If Reporting <br />,FiifltyiTtN(.).4iN,Sut)awardee, tinier Name and <br />Address ofPrune: <br />❑ Prime ❑ Subwardee <br />Tier­, �fkntnvn <br />Con -essional Distr known <br />6. Federal Department/Agency: 7, Foderal Program NameMescription <br />CFDA Nurrilhor, If arpllcable <br />S. Fedeml Action Number, Ji'Anotwi 9, AA,,,,trd Amount, J)"known <br />S—'­-­-­ ­- <br />7-111dividual —Putormalasm <br />10.a. Narne aid Address of Lobbying Ehthy rnd1)gScrvioes(n*e&g <br />!knYrxmr,�tr5rrenrz', rill <br />lailarih Continuation Sltee. Is) if nocassary) <br />11. Amount ofTaymerit (cbeck all that apply) 13. Type of payment (check all that apply) <br />a . retainer <br />b, one-drse fee <br />12. Form of Payment (check all that apply): ❑ C. commission <br />❑ a. cash ❑ d. contingent fie <br />❑ lo, in-kind; specify, nature ❑ e. detoured <br />riles ❑ f other, <br />14. Briet'Description of Services Pertbrated or to he performed and Dates) of'Survim including office4a), oraployee(s), or aiembMsa contactact, for <br />Payment indicated in item 11: <br />(attach Contimicifion Vwel s iY I necvssajv) <br />15. Conti Yes No <br />Print Name <br />xdvA[ tvavailable krpubtic- insaaction. <br />Any pawa Mu tals, To filerhem#cd diselmire"I be af4ectio acidl penally of Title.. <br />not <br />Pete phone Nm Date <br />Bodand UscOrly: Authorzol firl Ax:aI fict)ioductimi <br />Standard Form LLJ- <br />TO BE INCLUDED IN BID PACKAGE <br />BP 23 of 29 <br />