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. Contractor/Organization Name;
/y/7^,^ [/^-. ^
/ (/
1*'*^—.
2. Type of Entity:
'^non-govemment a nonprofit 501(c)(3), (4), or (6)
3. Name(s) of trustees, directors, partners, officers of Contractor/Organizatton:
A4^. ^M} ^^ <'<,
v • ~ aly
S^-C^/G^- — ^fff-^A fyyrW3l&,» " ^^^('^~
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/Organization:
/^•/^ M^,J .oj»^y
~u
^]cAsj j4»A M».ts&s^inA^/L^^-'t5.€^--^T
/ ''
Prepared by: ^f}/^ //,
Title: /J^<-f4^r^
Phone: ^/^ ^ffL^^
Date: p^^, ,^L_^^^-
Rev.07.10.2007