Disclosure Pursuant to the
City of Pasadena Taxpayer Protection Amendment
Pasadena City Charter, Article XVII
Contractor/Organization hereby discloses its trustees, directors, partners, officers, and those with more than 10% equity, participation, or revenue interest in Contractor/Organization, as follows:
(If printing, please print legibly. Use additional sheets as necessary.)
1. Co||tractor/0rgaqization Namtractor/ureaauzanon iName^ ,-—" ^o^W ~^^y^ /^!^L^^s'^TZ
2. Type of Entity:
< non-govemment D nonprofit 501(c)(3), (4), or (6)
3. Napless) of trustees, directors, partners, officers ofContractor/Oreanization:
^ //G%<g2^^<ff//wL
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/OrEanization:
Prepared by: I^W4/ ^- /^^^
T^ie: ^^^/r-
Phone: W-C/lf-WOQ
Date: ^V^^
Rev.07,10.2007