City of Glendale
DISCLOSURE - CAMPAIGN FINANCE ORDINANCE
The City Council adopted Ordinance No. 5744, “Campaign Finance Ordinance,” which became effective on September 9, 2011, and amended it with Ordinance No. 5768, which became effective on March 15, 2012 (“the Ordinance”). The Ordinance prohibits: (1) A contractor* (including a subcontractor**)― who has a contract with the City of Glendale (“City”), Economic Development Department (“EDD”), or the Housing Authority of the City of Glendale (“HA”) and that contract is subject to approval by the City Council, EDD, or HA― from making a contribution to a City Council member, EDD member, HA member, City Clerk, or City Treasurer; and (2) Council members, EDD members, and HA members from voting on matters concerning a contract with a person who has provided a campaign contribution.
The Ordinance applies to a contractor whose contract requires the City Council’s, EDD's, or HA’s approval. A contract with the City, EDD, or HA is known as a “City Contract.” The Ordinance also applies to a subcontractor who has a subcontract through a City Contract. The Ordinance excludes a competitively bid contract awarded to the lowest responsible bidder.
To assist members of the City Council, EDD, and HA before they vote on a matter regarding a City Contract, the Ordinance requires City staff to prepare this report which discloses certain information about: the contractor receiving the City Contract, and the subcontractor(s) working under the City Contract.
A contractor must provide the information listed below when: A subcontractor must provide the information listed below when:
•The City Contract has a total anticipated or actual value of $50,000 or more; or • The subcontract through a City Contract has a total anticipated or actual value of $25,000 or more; or
• A combination or series of City Contracts have a value of $50,000 or more. • A combination or series of subcontract s, for the same or different projects, have an aggregate value of $25,000 or
more. Information that must be disclosed: ● Name of the person, entity, or organization (i.e., the Contractor or Subcontractor) ● Name of the Chief Executive Officer/Pre
siden t
● Chief Operating Officer
● Chief Financial Officer
● Chairper
son
● All members of the Board of Directors
● All persons who own more than 10% of the perso
n, entity, or organi zation
● Name of any campaign committee owned or controll ed by the person, entity, or organization Please complete the following disclosure form:
Contractor(s)*:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
*“Contractor” is the person, entity, or organization that is the party, or prospective party, to the contract with the City, EDD, or HA or any member of that person’s, entity’s, or organization’s Board of Direct ors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operat ing Officer, any person with an ownership interest of more than ten percent (10%) in that person, entit y, or organization, and any campaign committee that is o wned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address.
Armenian Relief Society of Western USA, Inc. Social Services 517 W. Glenoaks Blvd., Glendale, CA 91202 Vicky Marashelian 517 W. Glenoaks Blvd. Glendale CA 91202 Shooshig Susan Avakian 517 W. Glenoaks Blvd. Glendale CA 91202 517 W. Glenoaks Blvd. Glendale CA 91202
517 W. Glenoaks Blvd. Glendale CA 91202
Ruzanna Mkrtchyan
Maral Manokian, Secretary
Rev. 6/7/12 J:\FILES\DOCFILES\ORD\CAMPAIGN CONTRIBUTION\DISCLOSURE FORM – CONTRACTOR – 6-7-12.doc Subcontractor(s)**:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** “Subcontractor” is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or gener al or prime contract, usually by a general or prime contrac tor. Subcontractor includes any member of that person’s, entity’s, or organization’s Board of Directors, its Chairperson, Chief Executive Officer, Chief Financ ial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named Contractor Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute― or if I select additional ― architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclo sure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and I have been legally authorized to su bmit this disclosure form.
In total, this disclosure form (including attachments) is pages.
Executed on: , 20 , at: , California.
Signature: Print Full Name:
Address:
Phone Number: E-mail Address:
x
3 May 10 24 Glendale
Shooshig Susan Avakian
517 W. Glenoaks Blvd., Glendale CA 91202
818-241-7533 [email protected]
ՀԱՅ ՕԳՆՈՒԹԵԱՆ ՄԻՈՒԹԵԱՆ
ԱՐԵՒՄՏԵԱՆ ՄԻԱՑԵԱԼ ՆԱՀԱՆԳՆԵՐՈՒ
ԸՆԿԵՐԱՅԻՆ ԾԱՌԱՅՈՒԹԵԱՆ ԳՐԱՍԵՆԵԱԿ
ARMENIAN RELIEF SOCIETY
OF WESTERN USA, INC.
SOCIAL SERVICES
ARS Regional Executive Board
2023-2024
• Vicky Marachelian, Chairperson
City of Residence: Burbank, CA
• Emma Garabetian, Vice-Chairperson
City of Residence: La Crescenta, CA
• Maral Manokian, Secretary
City of Residence: Porter Ranch, CA
• Christina Khanjian, Treasurer
City of Residence: Los Angeles, CA
• Seda Khojayan, Advisor
City of Residence: Glendale, CA
• Anush Chalian, Advisor
City of Residence: Calabasas, CA
• Haigo Barsamian, Advisor
City of Residence: Reseda, CA
• Eugenie Shamlian-Aroyan, Advisor
City of Residence: Glendale, CA
• Shoushan Tashjian, Advisor
City of Residence: Mountain View, CA
*ARS Board Members are members of the Armenian Relief Society of Western USA, as well as other community organizations.
MARCH 2024 ** Preferred means of communication
BOARD OF DIRECTORS
CHAIR:
Tyler Lazarian (Melissa)
Chief Executive Officer, Electric Service & Supply Co.
2668 E. Foothill Blvd
Pasadena, CA 91107
1490 North Grand Oaks Avenue
Pasadena, CA 91104
Cell: 626-354-8474
[email protected]
VICE-CHAIR:
Sarah Silk (Mark)
Community Volunteer
2929 Larmona Dr
Pasadena, CA 91107
Home: 626-794-1853
Cell: 818-601-1636
[email protected]
TREASURER & CHAIR OF THE FINANCE COMMITTEE:
Robert Lagace (Ruth)
Managing Director for Los Angeles Middle Market Banking Group, JPMorgan Chase (Retired)
932 Encanto Dr.
Arcadia, CA 91007
Cell: 626-348-3781
[email protected]
SECRETARY & CHAIR OF BOARD GOVERNANCE
COMMITTEE:
Dick Kleinert (Darleen)
Principal, Deloitte Consulting LLP, (Retired)
196 S. Orange Grove Blvd. #303
Pasadena, CA 91105
Cell: 818-356-5015
[email protected]
CHAIR OF THE DEVELOPMENT COMMITTEE
Jen Argue (Steve)
Life Coach & Business Coach, Life Coaching Collective
3135 Rubio Canyon Rd.
Altadena, CA 91001
Cell: 616-516-0562
[email protected]
MEMBERS:
Brian Kim (Emily)
Portfolio Manager, Northern Trust
2830 Adams St
La Crescenta-Montrose, CA 91214
Cell: 213-270-4905
[email protected]
Charlie Plowman (Sandra)
Publisher, Outlook Newspapers
800 Foothill Blvd
La Canada Flintridge, CA 91011
5535 Burning Tree Dr.
La Canada, CA 91011
Cell: 818-952-7000**text
[email protected]
David Bunn (Kellie)
Attorney, Bunn & Bunn
1112 Fair Oaks Ave
South Pasadena, CA 91030
626-792-9421**
2504 North Holliston Avenue
Altadena, CA 91001
Cell: 626-372-1306
[email protected]
David Lee (Katherine)
Chairman & CEO, Hing Wa Lee Group
19345 San Jose Ave
Industry, CA 91748
909-869-0900
Cell: 626-922-8888
[email protected]**
Gerson Munoz (Seline Guidotti)
Asset Manager, Housing Authority of the City of LA
1558 Winchester Ave
Glendale, CA 91201
Cell: 323-708-5791
[email protected]
Joseph Montes (Sarah)
Attorney, Burke, Williams, & Sorensen, LLP
2040 Sinaloa Ave
Altadena, CA 91001
Cell: 626-533-8345
[email protected]
Kay Wolking (Sandy)
Regional Managing Director for Pasadena Private Banking, Wells Fargo (Retired)
1214 Flintridge Circle, La Canada Flintridge, CA 91011
Cell: 818-298-9424
[email protected]
Kimberly Kirui
Community Engagement Associate, Imagine LA
834 W Duarte Rd, Apt 13 A
Arcadia, CA 91007
Cell: 818-649-4789
[email protected]
DOOR OF HOPE STAFF:
Megan Katerjian (Harout)
Chief Executive Officer, Door of Hope
351 E Calaveras St
Altadena, CA 91001
Home: 818-790-6708
Cell: 626-394-4884
[email protected]
City of Glendale
DISCLOSURE - CAMPAIGN FINANCE ORDINANCE
The City Council adopted Ordinance No. 5744, “Campaign Finance Ordinance,” which became effective on September 9, 2011, and amended it with Ordinance No. 5768, which became effective on March 15, 2012 (“the Ordinance”). The Ordinance prohibits: (1) A contractor* (including a subcontractor**)― who has a contract with the City of Glendale (“City”), Economic Development Department (“EDD”), or the Housing Authority of the City of Glendale (“HA”) and that contract is subject to approval by the City Council, EDD, or HA― from making a contribution to a City Council member, EDD member, HA member, City Clerk, or City Treasurer; and (2) Council members, EDD members, and HA members from voting on matters concerning a contract with a person who has provided a campaign contribution.
The Ordinance applies to a contractor whose contract requires the City Council’s, EDD's, or HA’s approval. A contract with the City, EDD, or HA is known as a “City Contract.” The Ordinance also applies to a subcontractor who has a subcontract through a City Contract. The Ordinance excludes a competitively bid contract awarded to the lowest responsible bidder.
To assist members of the City Council, EDD, and HA before they vote on a matter regarding a City Contract, the Ordinance requires City staff to prepare this report which discloses certain information about: the contractor receiving the City Contract, and the subcontractor(s) working under the City Contract.
A contractor must provide the information listed below when: A subcontractor must provide the information listed below when:
•The City Contract has a total anticipated or actual value of $50,000 or more; or • The subcontract through a City Contract has a total anticipated or actual value of $25,000 or more; or
• A combination or series of City Contracts have a value of $50,000 or more. • A combination or series of subcontract s, for the same or different projects, have an aggregate value of $25,000 or
more. Information that must be disclosed: ● Name of the person, entity, or organization (i.e., the Contractor or Subcontractor) ● Name of the Chief Executive Officer/Pre
siden t
● Chief Operating Officer
● Chief Financial Officer
● Chairper
son
● All members of the Board of Directors
● All persons who own more than 10% of the perso
n, entity, or organi zation
● Name of any campaign committee owned or controll ed by the person, entity, or organization Please complete the following disclosure form:
Contractor(s)*:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
*“Contractor” is the person, entity, or organization that is the party, or prospective party, to the contract with the City, EDD, or HA or any member of that person’s, entity’s, or organization’s Board of Direct ors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operat ing Officer, any person with an ownership interest of more than ten percent (10%) in that person, entit y, or organization, and any campaign committee that is o wned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address.
Rev. 6/7/12 J:\FILES\DOCFILES\ORD\CAMPAIGN CONTRIBUTION\DISCLOSURE FORM – CONTRACTOR – 6-7-12.doc Subcontractor(s)**:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** “Subcontractor” is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or gener al or prime contract, usually by a general or prime contrac tor. Subcontractor includes any member of that person’s, entity’s, or organization’s Board of Directors, its Chairperson, Chief Executive Officer, Chief Financ ial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named Contractor Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute― or if I select additional ― architects, design professionals, contractors, or subcontractors with
in ten (10) days of the selection or change; and
• I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is pages. , 2024 , at: , California.
Print Full Name:
Address:
Phone Number:
3 Glenadale
1255 S. Central Avenue , Glendale CA, 91204
818-548-2790 E-mail Address: [email protected] Glendale Youth Alliance 1255 S. Central Avenue, Glendale CA 91204 1255 S. Central Ave. Glendale CA 91204Dr. Vahe Peroomian Karine Grigoryan 1255 S. Central Ave. Glendale CA 91204 1255 S. Central Ave. Glendale CA 91204Ani Keshishian
Please see attached
N/A
x
Karine Grigoryan
Executed on: May 14
Signature:
GLENDALE YOUTH ALLIANCE BOARD OF DIRECTOR
Address: 1255 S. Central Avenue, Glendale CA 91203
Executive Board
Dr. Vahe Peroomian, Chair
Professor –USC
(818) 6
02-0276 [email protected]
Ani Keshi
shian, Treasurer
PDC of GCC
(661)257-0264 Cell [email protected]
Brielle A
cevedo, Secretary
Citi Community Capital
(818)404-2762 Cell [email protected]
Dr. Armina Gharpetian, Past Chair
Dentist
(818)3
14-1169 [email protected]
Board of Directors
Christopher Anwary
LA County Public Health
(818)572-7843 Cell [email protected]
Caroline Caun,
Ellis Family Stores
[email protected]
Lt. Mark Hess
Glendale Police Department
(818) 6
12-5582 [email protected]
Aylin Isayan
City of Glendale
(818)521-8808 Cell [email protected]
Dr. Ilin Magran
Senior Adjunct Professor at University of La Verne
(818) 4
34-2504 [email protected]
Rob Mikitarian
Glendale Adult Health Day Care
(818) 6
52-8800 Cell [email protected]
Narine Petrosyan
Pogosian Tax Planning Inc.
(818) 6
89-3404 [email protected]
Capt. Rafael Quintero
Glendale Police Department
(818) 2
62-4330
[email protected]
Art Re
sendez
California Trust Bank
(818) 7
26-2349
arthur.res
[email protected]
Lusine Yari
an
Glendale Police Department
(818) 9
37-8815
[email protected]
City of Glendale
DISCLOSURE - CAMPAIGN FINANCE ORDINANCE
The City Council adopted Ordinance No. 5744, “Campaign Finance Ordinance,” which became effective on September 9, 2011, and amended it with Ordinance No. 5768, which became effective on March 15, 2012 (“the Ordinance”). The Ordinance prohibits: (1) A contractor* (including a subcontractor**)― who has a contract with the City of Glendale (“City”), Economic Development Department (“EDD”), or the Housing Authority of the City of Glendale (“HA”) and that contract is subject to approval by the City Council, EDD, or HA― from making a contribution to a City Council member, EDD member, HA member, City Clerk, or City Treasurer; and (2) Council members, EDD members, and HA members from voting on matters concerning a contract with a person who has provided a campaign contribution.
The Ordinance applies to a contractor whose contract requires the City Council’s, EDD's, or HA’s approval. A contract with the City, EDD, or HA is known as a “City Contract.” The Ordinance also applies to a subcontractor who has a subcontract through a City Contract. The Ordinance excludes a competitively bid contract awarded to the lowest responsible bidder.
To assist members of the City Council, EDD, and HA before they vote on a matter regarding a City Contract, the Ordinance requires City staff to prepare this report which discloses certain information about: the contractor receiving the City Contract, and the subcontractor(s) working under the City Contract.
A contractor must provide the information listed below when: A subcontractor must provide the information listed below when:
•The City Contract has a total anticipated or actual value of $50,000 or more; or • The subcontract through a City Contract has a total anticipated or actual value of $25,000 or more; or
• A combination or series of City Contracts have a value of $50,000 or more. • A combination or series of subcontract s, for the same or different projects, have an aggregate value of $25,000 or
more. Information that must be disclosed: ● Name of the person, entity, or organization (i.e., the Contractor or Subcontractor) ● Name of the Chief Executive Officer/Presiden
t
● Chief Operating Office
r
● Chief Financial Officer
● Chairperson
● All members of the Board of Directors
● All person
s who own more than 10% of the person, entity, or organi zation
● Name of any campaign
committee owned or controlled by the person, entity, or organization Please complete the following disclosure form:
Contractor(s)*:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
*“Contractor” is the person, entity, or organization that is the party, or prospective party, to the contract with the City, EDD, or HA or any member of that person’s, entity’s, or organization’s Board of Direct ors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operat ing Officer, any person with an ownership interest of more than ten percent (10%) in that person, entit y, or organization, and any campaign committee that is o wned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address. 3255 Wilshire Blvd., Suite 1150
Javier Beltran
Danny Batalla
Same as above
None
Chancela Al-Mansour
Same as above
/Board President
Dennis Perez
Southern California Housing Rights Center dba Housing Rights Center 3255 Wilshire Blvd., Suite 1150, Los Angeles, CA 90010
Los Angeles, CA 90010
Dennis Perez Please see attached list
Please see attached list
Rev. 6/7/12 J:\FILES\DOCFILES\ORD\CAMPAIGN CONTRIBUTION\DISCLOSURE FORM – CONTRACTOR – 6-7-12.doc Subcontractor(s)**:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** “Subcontractor” is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or gener al or prime contract, usually by a general or prime contrac tor. Subcontractor includes any member of that person’s, entity’s, or organization’s Board of Directors, its Chairperson, Chief Executive Officer, Chief Financ ial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named Contractor Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute― or if I select additional ― architects, design professionals, contractor
s, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any
attachment to this form) is true, accurate, correct, and complete; and I have been legally auth
orized to submit this disclosure form.
In total, this disclosure form (including attachments) is pages.
Executed on: , 20 , at: , California.
Signature: Print Full Name:
Address:
Phone Number: E-mail Address:
n/a
1 May 14, 2024
24 Los Angeles
3255 Wilshire Blvd., Suite 1150, Los Angeles, CA 90010
213-387-8400 x1111
[email protected]
Chancela Al-Mansour
Chancela Al-Mansour
None.
B
oard of Directors January 2024
Denni
s Perez, President
Hochman, Salkin,Toscher & Perez, P.C.
9100 Wilshire Blvd., Suite 900W
Beverly Hills, CA 90212-3414
Term Expires 6/30/24
Al
isa Schlesinger, Vice President
Walt Disney Pictures
500 S. Buena Vista St.
Burbank, CA 91521
Te
rm Expires 6/30/24
Rober
t Kitson, Secretary
Myers Law Group
6464 Sunset Blvd., Ste. 1070
Hollywood, CA 90028
Term Expires 6/30/24
Rober
t K. Johnson, Treasurer
Munger, Tolles & Olson LLP
350 S. Grand Avenue, 50
th Floor
Los Angeles, CA 90071
Term Expires 6/30/24
S
ofia Aguilar
NBC/Universal
100 Universal City Plaza
Building 1440, Suite 1600
Universal City, CA 91608
Te
rm Expires 6/30/24
A
aron Bloom
TroyGould PC
1801 Century Park East, Ste. 1600
Los Angeles, CA 90067-2367
Term Expires 6/30/24
Grant Habata
Law Office of Grant M. Habata
2118 Wilshire Boulevard, #353
Santa Monica, CA 90403
Term Expires 6/30/24
A
udrey M. Harris Yoga Instructor
1517 Westholme Ave
Los Angeles, CA 90024
Term Expires 6/30/24
A
aron M. May
Halpern May Ybarra Gelberg LLP
550 S. Hope Street, Suite 2330
Los Angeles, CA 90071
Term Expires 6/30/24
G
rant Michaelson
Vice President, Business Affairs and New Media
ABC Entertainment
500 S. Buena Vista St.
Burbank, CA 91521
Te
rm Expires 6/30/24
A
lexander K. Robinson
Gibson, Dunn & Crutcher LLP
333 South Grand Avenue, Los Angeles, CA
90071-3197
Term Expires 6/30/24
K
enneth Trujillo-Jamison Willenken LLP
707 Wilshire Blvd., Suite 3850
Los Angeles, CA 90017
Te
rm Expires 6/30/24
Advisory Board
Marjie Mautner
3715 Valley Meadow Rd.
Encino, CA 91436
(818) 986-3356
(818) 986-33 57 fax
[email protected]
City of Glendale
DISCLOSURE - CAMPAIGN FINANCE ORDINANCE
The City Council adopted Ordinance No. 5744, “Campaign Finance Ordinance,” which became effective on September 9, 2011, and amended it with Ordinance No. 5768, which became effective on March 15, 2012 (“the Ordinance”). The Ordinance prohibits: (1) A contractor* (including a subcontractor**)― who has a contract with the City of Glendale (“City”), Economic Development Department (“EDD”), or the Housing Authority of the City of Glendale (“HA”) and that contract is subject to approval by the City Council, EDD, or HA― from making a contribution to a City Council member, EDD member, HA member, City Clerk, or City Treasurer; and (2) Council members, EDD members, and HA members from voting on matters concerning a contract with a person who has provided a campaign contribution.
The Ordinance applies to a contractor whose contract requires the City Council’s, EDD's, or HA’s approval. A contract with the City, EDD, or HA is known as a “City Contract.” The Ordinance also applies to a subcontractor who has a subcontract through a City Contract. The Ordinance excludes a competitively bid contract awarded to the lowest responsible bidder.
To assist members of the City Council, EDD, and HA before they vote on a matter regarding a City Contract, the Ordinance requires City staff to prepare this report which discloses certain information about: the contractor receiving the City Contract, and the subcontractor(s) working under the City Contract.
A contractor must provide the information listed below when: A subcontractor must provide the information listed below when:
• The City Contract has a total anticipated or actual value of $50,000 or more; or • The subcontract through a City Contract has a total anticipated or actual value of $25,000 or more; or
• A combination or series of City Contracts have a value of $50,000 or more. • A combination or series of subcontract s, for the same or different projects, have an aggregate value of $25,000 or
more. Information that must be disclosed: ● Name of the person, entity, or organization (i.e., the Contractor or Subcontractor) ● Name of the Chief Executive Officer/President
● Chief Operating Officer
● Chief Financial Officer
● Chairperson
● All members of the Board of Directors
● All persons who own more than 10% of the person, entity, or organization ● Name of any campaign committee owned or controlled by the person, entity, or organization Please complete the following disclosure form:
Contractor(s)*:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
* “Contractor” is the person, entity, or organization that is the party, or prospective party, to the contract with the City, EDD, or HA or any member of that person’s, entity’s, or organization’s Board of Direct ors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operat ing Officer, any person with an ownership interest of more than ten percent (10%) in that person, entit y, or organization, and any campaign committee that is o wned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address.
Rev. 6/7/12 J:\FILES\DOCFILES\ORD\CAMPAIGN CONTRIBUTION\DISCLOSURE FORM – CONTRACTOR – 6-7-12.doc Subcontractor(s)**:
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** “Subcontractor” is the person, enti ty, or organization that has entered into a c ontract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or gener al or prime contract, usually by a general or prime contrac tor. Subcontractor includes any member of that person’s, entity’s, or or ganization’s Board of Directors, its Chairperson, Chief Executive Officer, Chief Financ ial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Above please disclose these persons’ name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named Contractor Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute ― or if I select additional ― architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is pages.
Executed on: , 20 , at: , California.
Signature: Print Full Name:
Address:
Phone Number: E-mail Address:
ArmenianBarAssociationP.O.Box29111,LosAngeles,CA90029
ArmenianBar.org|[email protected]
BoardofGovernors
ExecutiveCommittee
LucyVarpetian-Chairwoman
StevenDadaian-ViceChair
ZavenSargsian-Secretary
MesropKhoudagoulian-Treasurer
TalineSahakian-ChairExOfficio
MembersatLarge
Hon.AmyAshvanian
AlexHragBastian
GiselleDavidian
HarryH.Dikranian
LevonGolendukhin
GrantHanessian
ArmenK.Hovannisian
SourenIsraelyan
MariamKuregyan
TigranPalyan
OvsannaTakvoryan
SarahLeahWhitson
NALSARepresentative
DianaGazaryan