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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 1.5-6834 <br />TRAFFIC SIGNAL MODIFICATIONS: 17(" STREET AT ENGLISH STREET, <br />MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE <br />AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET <br />FEDERAL PROJECT NO: HSIPL 5063(156) <br />DISCLOSURE OF LOBBYING ACTIVITIES <br />DISCLOSURE OF LOBBYING ACTIVITIES Apaowabyoa+a <br />Complete this force to disclose krbbying activities pursuant M 31 U_S.C. 1352 u 8-0016 <br />(See reverse for oubbfic burden disc] .T <br />1. Type of Federal Action: <br />2. Status of Federal Axtion: <br />3. Report Type: <br />❑a. contract <br />a. bidlolfer7ap;A:.l m <br />El a. initial filing <br />b. grant <br />b_ initial award <br />b, numeriai change <br />c. txroperativa agreement <br />o. pcstaward <br />For Material Change Ontj: <br />d. loan <br />year 9uartsr <br />a- loan guarantee <br />date oflastrepon <br />f. loan insurance <br />4_ Name and Address of Reporting Entity: <br />5. If Reporting Entity in No. 4 is a Submiai e, Enter Name <br />El Pratte [] aubawwooc <br />and Address of Prime: <br />Tier__ ifknown: <br />Con ressional Distrixt. ifkncwn: <br />Congressional District ,.dtrmwn: <br />B. Federal OeparMranUAgency: <br />7, Federal Program:'Description: <br />CFDA Number Wtde: <br />S. Federal Action Number, ifknown:3. <br />Award unf, ifknowrr: <br />S <br />10, a. Name and Address of Lobbying Entity b. In ' ' mats Perfonning Services (incduding address tf <br />(ifindiwduat, last name.. first name. Ml): Brent Ifean No. Iva) <br />(last name, first name. Ml): <br />atGd, t:A m Ste 's u^F{Lt0. Nneceme <br />11. Amount of Payment (check all Ihat appfY): <br />13. Type of Payment (check aft that apply):. <br />$ .... [Jactual El[Ia <br />rahiiner <br />r7b. ole-Nma Tea <br />❑ e. Marchand <br />12. Form of Payment (check ad Pham Y. <br />p a each <br />❑ d aordl gNA ora <br />Q b, I"mo. apeeW nature <br />El 0. decided <br />value .— <br />❑to(lam1paa8y:_, <br />14. Brief Description of Se as Performed or to be Performed and Date(s) of Service, including officer(s), <br />employea(si, or Memb r(s) contacted, for Payment Indicated in than 11: <br />atna�CdntNuaibn 3rmak's SF{ knLte <br />15- Contlnuatin Sheets SF-L.LLA attached: Uyart No <br />tg• 1Y53. PN, . d'diePP,a uxr+t� • as+e6+ 9 },rww sa ¢I fC <br />$ignatV(e: <br />Print Name: <br />y...ux ... p..+hxnr—. �.�rue,..Mra.a mar. <br />u.+..r.. ,.ww w.,.e m si ux:u usx oar <br />Title: P rcgJLIPp j, --.— <br />.e. ww,.cmuumm m,c..,r..•..,a.....wy.,a.n <br />m.a,tc.++b.t..ii...xa i,Rmu.,ana�:.. a.n sroxms r.. <br />Telephone No.: 626-810-133a-Date:O 104/ 016 <br />AaTglietl ter Loa Reproreart e <br />Federal Use Only: <br />ilYddaard Farm LLt Rau. T J] <br />P-25 of P-40 <br />20D-40 <br />