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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.:15-6831 <br />CROSSWALK UPGRADES - PHASE I <br />FEDERAL PROJECT NO: HSIPL 5063(155) <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />DISCLOSURE OF LOBBYING ACTIVITIES Approved by OUB <br />Complete this form to disclose lobbying activilies pursuant to 31 U.S.C. 1352 DUBO Ws <br />See nonuse for ovAuburdendisclosure_ <br />1. T of Federal Action: <br />2. Status of erA Action: <br />3. Repo Type: <br />a. contract <br />a- bidl oRerlapplication <br />a. initial filing <br />b. grant <br />b. initial award <br />b. matertal change <br />a cooperative agreement <br />c. post -award <br />For Material Change Only: <br />d. lean <br />year quarter <br />e. loan guarantee <br />date of last report <br />f. loan Insurance <br />4. Warn"rid Address of Reporting Etffity: <br />S. N Reporting Earthy in No. 4 is a Subawardee, Ender Name <br />drtw D straw adw <br />and Address of Prime: <br />Tier_, ifknowm: <br />/^ 1 <br />vl%L6ro liy w.vb.Pw'A.C-e��'tov�s btr.s�rrn.t.f"l�d' <br />Q <br />ba® r . Vf�d (^jeW AV-ffua.t- <br />c-ov+Qhov\t c -A ckoT.1- <br />Comaressional District, dAratwn: <br />Congressional flfstriot rTkrrcwt; <br />8. Federal Ovp�ar ner�d/llften oy: <br />7. Federal Program NamalDescriptiow <br />t y \ `X <br />CFUA Number. if apSo �S L 7 o ba US S) <br />8. Federal Action Number, yAadwm: <br />$. Award Amount, r7kntrwm: <br />\ Ak, <br />S N \ <br />18. a. Name and Address of t obby§rg EnW b. lrstividuals Perlortow" Ser»ces (Mclud&{g address rl <br />(if indcv oxi, last name. nrsf name. Ml): otnerent Munn No. lga) <br />(last r+ame. NMI mance, Ml): <br />r, ,tom <br />AOP� tl\f-, <br />atoe�tdxrtpaanarsae stinittt.# <br />11. Amount Ppayment (olteak alfOW apply): <br />13. Type of Payment (cheoR all that apply): <br />�d'f� <br />0 b*m ❑ Narrrrw <br />D. t*oknr <br />D r.,madimame <br />D c, wn.wuwn <br />12. Form of payment(check a#.Matapp ly): <br />D a oen <br />N <br />D d CdlWlgartraa <br />\ <br />D a, tn4um epaay: rape <br />❑ c mtrrwt V ` <br />vakte <br />D r.alwr: epacay: <br />14. Brief Description of Ser Aces Performed or to be Perlonned and Uatels) of Service, including officer(s), <br />employee(s), or Membar{s) contacted, for Payment lndioated in Item 11: <br />N\� <br />atn4yl Giatltmffiipt 6 Sl^diLq #rkaF <br />15. continuation She 5 SF4:G€A. attached: Yam PrW <br />l3evYv, �.ybG pv+p�N, NnrsNWW Mip . Yw <br />16. rt VAC <br />, M aey.,.. A snra,a f:n.. s . a.rru wp.rwumr, a ra <br />Signature: <br />, <br />e Print Nam2- <br />my..,wme.,.ro.wpsrgd.. r..mu.sw+w. <br />R, a...e"Ma,..x. <br />rha9 bIn lFw 6.ryn a .ybW wwwp b 4Y Uri# R1 <br />Thle:yP_ <br />wa.b t✓a rm w e.+« do «amaaaw....rd. r. <br />�j��'1z.�,tJ- <br />rt <br />Telephone No.: _SA 4 q Date: �=�„t�,�. <br />s31M bYfMM+af tl'rtLlr b iW.tPo YMPRow. filo iIOgMR M <br />wn.ccsa.a. <br />Federal tfse Orly: <br />Aufta tl W UMA Rel"Mcl on <br />Sfaldad rum tk/. Ren. -f-gri <br />P -25 of P-40 <br />.�M� <br />t - <br />