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INSTRUCTIONS FOR COWLETION OF SF -LLL
<br />DISCLOSURE OF LOBBYING ACTIVITIES
<br />This disclosure form shall be completed by the reporting .entity, whether subawardee or prime Federal recipient; at the initiation or receipt ol•
<br />ravened federal action or a material change to previous riling pursuant to title. 31 i).S.C. section 1352. 'rhe filing Ora fortyt is required for such
<br />payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or cmplaycc of any agency, a
<br />Member of Congress an officer or employee of Congress or an olnployee of a Member of Congress in connection with x covered Fedcml action.
<br />Attach a continuation sheet for additional in iC the space on the form is inadequate. Complete ail items chat apply for bath the initial
<br />Fling and material change report. Refer to the Implementing guidance published by the Office of Management acid Budget for additional
<br />information.
<br />1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to infl
<br />Covereduence, the outcome of a
<br />Federal Action.
<br />2. Identify the status of the covered Pedwal action.
<br />3. Identify the appropriate classification year and of this report. If this is a follow-UPreport caused b a material chane to the intorntation
<br />Previously reported, enter the year and quarter in whictl the change occurred. Enter tate date of the last previously submitted report by
<br />this reporting entity for this covered Federal action.
<br />4. Enter the full name, address city, state all
<br />appropriate c]assitlaatian of the reporting; ezip Code of the reporting entity. Include Congressional District if kalown. Check the
<br />ntity that. designates if it is or expects to be a prime or subaward meipient. Identify Elie tier of
<br />the subawardee, e.g., the first suhawardee of the primo is the first tier. Subawards include but are not limited to subcontracts, subgrants
<br />and contract awards under grants.
<br />5. If the organixatio►i fling the report in Item, 4 checks "Subawardee" then cater the hill name, address, city, state and zip code of the
<br />pri 'no fed oral recipient. Include Congressional District, if known..
<br />G. Bitter the name of Hie Federal agony making the award or loan Commitment. Inchide at least one organization level below agency
<br />name, if known, For example, Departmcnt of Transportation, United States Coast Guard,
<br />7. Enter the Federal program name or description far the covered Federal action (item l). If known, enter the, fall Catalog of Federal
<br />Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and Ioan comnitmcnts.
<br />tt. Enter 1110 most appropriate Fedcrai identifying number available for the Federal. action identification in item l (c,g., Requesf far
<br />Proposal (RFP) number, Invitation for Bid (IFB) number, grant a1snouncelnent number, the contract grant. or loan award number, the
<br />appltcation/pruposat control number assigacd by the Federal agency). Include prefixes, e.g., " RFP-I7Ii-g0-001."
<br />9. For a covered Federal action where there has bean alt award or loan commit merit by the Federal agency, enter the Federal amount of the
<br />award/]oan commitments for the prime entity identified in item 4 or S.
<br />10. (a) Enter the full name,. address, city, state rend zip code of cite lobbying entity engaged by the reporting entity identified in titer 4 to
<br />influenced the covered Federal action.
<br />(b) Enter the full names of the individual(s) perforating services and include full address if different from 10 (a). Enter Last Name, First
<br />Name and Hddle.Initial (M1).
<br />11. Leiter the amount of compelts'ation paid or reasonably expected to be paid by the reporting entity (item 4) to tiro lobbying entity (item
<br />IO). Indicate whether the Payment has been made (actual) or will be ruade (planned). Check all boxes that apply, if this is a material
<br />change report, enter the cunluiative amount of payment made or planned to be made.
<br />12. Check the appropriate box. Check all boxes that apply, If payment is made through all in-kind contribution; specify the nature and value
<br />of the in-kind payme;lt.
<br />1.3. Check the appropriate box. Cheek al l boxes that apply. if other, specify nature.
<br />1.4. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)
<br />Of any services rendered_ Include ail prepamtory and related activity not just time spent in actual contact with Federal officials. Identify
<br />the Federal officer(s) or employee(s) coutacted or the officer(s) employee($) or Mernhcr(s) of Congress that were contacted.
<br />l5. Cheek whether or not a continuation sltcet(s) fs attached.
<br />16. The certifying official shall sign and date time form, print his/her name title and telephone number.
<br />Public reporting burden for this collection of information is estimated to average 30 minutes per response, iftoluding time for reviewing
<br />instruction, searching existing data sou ccs, gathering grid maintaining the data needed, and completing and reviewing the oallectian of
<br />information. Send comments regarding the btlydarm estimate or any other aspect of this collectiot=
<br />Of information, including suggestions for
<br />reducing this burden, to the Office of Management and Budget Paperwork Reduction Project (0348.0046), Washington, D.C. 20503.
<br />BID FORMS
<br />REDWOOD CITY PAVEMENT PRESERVATION PROJECT 00400-12
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