Disclosure Pursuant to the
City of Pasadena Taxpayer Protection Amendment
Pasadena City Charter, Article XVII
Confractor/Qrganization {lereby discloses Its trustees, directors, partners, officers, and those w.ith more than 10% equity, participation, or revenue iiiterest in Contractor/Organizatton, a§ follows:
(lfprmtms> please print ksilfly. Use ciddilwwl sheets as wcesswy.} 1, Contt'aclor/Orgarilzationi Name;
Gang Interventionist/Consultant
2. Type ofEntity:
X3 non-goveminertt Q noripropt 50J(c)(3), (4), or (6)
3. Naitie(s) of trustefis, directprs, pstrtnei-s, officers of CQntractbr/OrganizatloR:
*.
"N7A"
4. Names of those witli moN than XOU/o equity, partjdpatioa or revenue interest jitt Coritractor/Organizafjon:
N/A
Prepared by: 'Kdwj'Pi^M
•f^le; Gang Interventionist/Consultanfc
Phone;626.525-9951
Dme: 6/17/2022
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Recjuest for Proposals - GANS VIOLENCE OUTREACH AND INTERftUPTION SERVICES Release Date: Wednesday, June 1, 202.2