Attachment C - Public
Integrity Disclosure Forms
CITY OF PALM SPRINGS – PUBLIC INTEGRITY
DISCLOSURE
APPLICANT DISCLOSURE FORM
(Revised 05/16/19)
PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
1. Name of Entity
2. Address of Entity (Principle Place of Business)
3. Local or California Address (if different than #2)
4. State where Entity is Registered with Secretary of State
If other than California, is the Entity also registered in California? Yes No
5. Type of Entity
Corporation Limited Liability Company Partnership Trust Other (please specify)
6. Officers, Directors, Members, Managers, Trustees, Other Fiduciaries (please specify) Note:
If any response is not a natural person, please identify all officers, directors, members, managers and other fiduciaries for the member, manager, trust or other entity
Officer Director Member Manager
[name]
General Partner Limited Partner
Other
Officer Director Member Manager
[name]
General Partner Limited Partner
Other
Officer Director Member Manager
[name]
General Partner Limited Partner
Other
Engineering Resources of Southern California, Inc.
1861 W Redlands Blvd., Redlands, CA 92373
77-564 Country Club Dr., Ste 128, Palm Desert, CA 92211 California
PAGE 1
Trent Brudin, PE - Secretary
Moe Ahmadi, PE - Vice President
John M. Brudin, PE - President
37 CITY OF PALM SPRINGS – PUBLIC INTEGRITY
DISCLOSURE
APPLICANT DISCLOSURE FORM
(Revised 05/16/19)
PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
1. Name of Entity
2. Address of Entity (Principle Place of Business)
3. Local or California Address (if different than #2)
4. State where Entity is Registered with Secretary of State
If other than California, is the Entity also registered in California? Yes No
5. Type of Entity
Corporation Limited Liability Company Partnership Trust Other (please specify)
6. Officers, Directors, Members, Managers, Trustees, Other Fiduciaries (please specify) Note:
If any response is not a natural person, please identify all officers, directors, members, managers and other fiduciaries for the member, manager, trust or other entity
Officer Director Member Manager
[name]
General Partner Limited Partner
Other
Officer Director Member Manager
[name]
General Partner Limited Partner
Other
Officer Director Member Manager
[name]
General Partner Limited Partner
Other
Engineering Resources of Southern California, Inc.
PAGE 2
Craig Brudin, LSIT, QSP - Treasurer
1861 W Redlands Blvd., Redlands, CA 92373
77-564 Country Club Dr., Ste 128, Palm Desert, CA 92211 California
38 7. Owners/Investors with a 5% beneficial interest in the Applicant Entity or a related entity
EXAMPLE
JANE DOE
[name of owner/investor]
50%, ABC COMPANY, Inc.
[percentage of beneficial interest in entity
and name of entity]
A.
[name of owner/investor]
[percentage of beneficial interest in entity
and name of entity]
B.
[name of owner/investor]
[percentage of beneficial interest in entity
and name of entity]
C.
[name of owner/investor]
[percentage of beneficial interest in entity
and name of entity]
D.
[name of owner/investor]
[percentage of beneficial interest in entity
and name of entity]
E.
[name of owner/investor]
[percentage of beneficial interest in entity
and name of entity]
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT.
Signature of Disclosing Party, Printed Name, Title Date
PENALTIES
Falsification of information or failure to report information required to be reported may subject you to administrative action by the City.
65%
John M. Brudin, PE
Moe Ahmadi, PE
15%
Trent Brudin, PE
10%
Craig Brudin, LSIT, QSP
10%
April 28, 2026
39 P a g e | vii
RFQ | On-Call Civil Plan Check Services (RFQ 02-26)
City of Palm Springs
SEC TION E | FORM S
A T T A C H M E N T “ D ” – P U B L I C I N T E G R I T Y
D I S C L O S U R E
P a g e | viii
RFQ | On-Call Civil Plan Check Services (RFQ 02-26)
City of Palm Springs
SEC TION E | FORM S