Disclosure Pursuant to the
City of Pasadena Taxpayer Protection Amendment
Pasadena City Charter, Article XVII
Contractor/Organization hereby discloses its tmstees, 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. C^ntractor/Organ^zation_Name: ^.^.^_ <. .. . _ A ,/r'
2. Type of Entity:
^lon-govemment a nonprofit 501 (c)(3), (4), or (6)
^~
3. Name(s) of trustees, directors, partners, officers ofContractor/Organization:^ uii CVI.UA a» ^^^Kl/^UDc?
^U^Nl PlMT^
'C> o^'\ U (<>^G.-2-
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/Organization:
^e-P-M^C^o ^^.V^^At^J^^
j^U>ST_^St£2^ D_OV^.'\^&0^^2:
Prepared by: -F!£- [2-^j^f^y 0 (2-\/^A'^^>
Title: 'PA9-TM&P-
Phone: /5l^ ^3<^-S>^<^^
Date: M^J^? , l^.'^OlS
7~-'T
Rev .07.10.2007