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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.:15 -683 l <br />CROSSWALK UPGRADES - PHASE I <br />FEDERAL PROJECT NO: HSIPL 5063(155) <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />DISCLOSURE OF LOBBYING ACTIVITIES ApRaedgovll <br />/ Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 a11Bap.16 <br />ISen - er neon hu,rinn McNncum 1 <br />1. T of Federal Action: <br />2. Status of eral Action: <br />3. Repo ype: <br />a. contract <br />a t dli rlappGcation <br />a. inAal filing <br />b. grant <br />b. initial award <br />b. material change <br />a. cooperative agreement <br />a post -award <br />For Material Change Only. <br />d. ban <br />year quarter <br />e. loan guarantee <br />date of last report <br />f. loan insurance <br />d. Nam nd Address of Reporting Entity: <br />S. If Reporting Entity in No. 4 is a Subawardee, Enter Name <br />❑ sleavrardaa <br />and Address of Prime: <br />Tier_ dMoivn: <br />I o v� 3 btni f r••t�l' <br />FlL �Ou�r1r10 C2o w.Vh w�nl v <br />1Lp�,.r <br />GotM�bIN t C_A Ck D L'-� <br />Con ressional District. iNumwn: <br />Congressional District. ifknorn: <br />6. Federal Deparart`mentlAgency: <br />T. Federal Program Name /Description: <br />` v \ `A <br />CFDA Number. if applicable: 5 L rj o (.3 U S r� <br />B. Federal Action Number, iflmmrn: <br />9. Award Amount, ifknown: <br />10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (khcuding address if <br />(ifindiidua1, last ram¢ Fi frlame. All): ditfererl hom No. Iga) <br />(lasfname, frstname. All): <br />"\ O( N \R <br />I <br />ffiti'm CantNirarm SmtaEISFLLL A rn[`:e <br />11. Amount of Payment (check all that apply): <br />13. Type of Payment (check all that apply): <br />S N 1h ❑ attain ❑ waaaid <br />❑ a meat" <br />❑ b one-sire no <br />❑ c. carmotaaton <br />12. Form of Payment (check all thatapply)c <br />❑ a east, <br />❑ a enntagemt re n ' <br />❑ b. tnamq spedy: naune <br />datmed <br />value <br />❑ Cotner, speedy. <br />14. Brief Description of Services Performed arto be Performed and Dates) of Service, including officer(s), <br />employee(s), or Member(s) contacted, for Payment Indicated in Item 11: <br />N \� <br />lalb]h CCaMuNIDa Saec781 SF1tLt rine(Y <br />1S. Continuation Sbeel s SF -LLLA attached: Lj Yoe Pr1io <br />16. �—'' .0 n w...a.. . y u. r uaa . <br />11 M.6ara,. d Od1h0 v' �� b . eWYI em�Nla� W eC <br />Signature: <br />Prim Name: r. <br />,,.TYM.nbe.� rh.w1MM V r.,tu t.nn., m n.b <br />Tate: V• / C. [� ( <br />,m.Ma.tN'9oYfLa. (bVO,- h....wY.a.tbwd�t.b <br />Telephone No : !34o � bw-2g Dat: y 2l l <br />..^a,b. ✓L haa!hanAly Mr!a�bnt,m. hn rG4fmb <br />..v.n1.. <br />Federal Use Only: <br />AIISWLad fir Lord re0tam�om <br />Gtae6ald rrsm lil ea.r4it <br />P -25 of P -40 <br />23A -36 <br />