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II. Officers or owners/investors of Applicant Entity. Please also disclose the following persons or entities related to the applicant entity: CEO/President, Chairperson, Chief Operations Officer, Chief Financial Officer, any member of the Board of Directors, and any individual or entity that owns 10% or more the contractor of applicant seeking entitlement, as well as any campaign + Full Name Title Business Address City State Zip
Ashot Arzumanyan Managing Member 326 Mira Loma ave. Glendale, CA, 91204 Glendale CA 91204 III. Contractor of Applicant(s) Seeking Entitlement*
Full Name Title Business Address City State Zip
Armine Galstyan Manageing Director 326 Mira Loma ave. Glendale, CA, 91204 Glendale CA 91204 * “Contractor of Applicant Seeking Entitlement” means “a person who has, or has been promised, a contract as an architect, design professional, engineer, or general or prime contract with an applicant seeking entitlement. “Contractor of applicant seeking entitlement,” includes not only the contracting party but also the CEO/President, Chairperson, Chief Operations Officer, Chief Financial Officer, any member of the Board of Directors, and any individual or entity that owns 10% or more the contractor of applicant seeking entitlement, as well as any campaign committee that is sponsored and controlled by the contracting party.
Please list the names and addresses of all of these parties.
IV. Subcontractor of Applicant(s) Seeking Entitlement** Full Name Title Business Address City State Zip
** “Subcontractor of Applicant Seeking Entitlement” means “a person who has, or has been promised, a subcontract as an architect, design professional, engineer, or perform other work with a ‘contractor an applicant seeking entitlement.”
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“Subcontractor of applicant seeking entitlement,” includes not only the subcontracting party, but also the CEO/President, Chairperson, Chief Operations Officer, Chief Financial Officer, any member of the Board of Directors, and any individual or entity that owns 10% or more the subcontractor of applicant seeking entitlement, as well as any campaign committee that is sponsored and controlled by the subcontracting party. Please list the name and addresses of all of these parties.
V. Disclosure. The Applicant Seeking Entitlement has made campaign or officeholder contributions in the preceding 12 months to City of Glendale elected officials as follows:
Elected Official Name of Individual or Entity Date of Contribution I hereby certify, on behalf of the above-named applicant(s) and owner(s)/lessor(s), that the applicant seeking entitlement has made the campaign contributions as set forth above. I also certify that the names of all contractors of applicant and all subcontractors of applicant, as of today’s date, are fully set forth above. I further acknowledge that the applicant has a continuing obligation to update this disclosure form if the applicant selects additional or substitute architects, design professionals, contractors or subcontractors within ten (10) days of the selection or change. I hereby certify that I have been legally authorized by the applicant/owner/lessor to submit this disclosure form and certify to the content hereof.
I declare under penalty of perjury that the foregoing is true and correct.
July 12, 2024 GlendaleExecuted on ___________________ at _____________________________, California Ashot Arzumanyan
________, Print Applicant’s Full Name ___________________________________ Applicant’s Signature____
1117 Elm Ave, Apt 107 Glendale, CA 91201Applicant’s Address _____________________________________________________________________ (650) 433-9038Applicant’s Contact Phone Number ________________________________________________________ [email protected]’s Email Address _______________________________________________________________
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