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:
^.<;.l<:--.,ld-ir\.1,;: •>- lJ^^^ac-_-^AL£x--.^'^k.^^'i-Tc^
2. Type of Entity:
"^ non-goveniment a nonprofit 501(c)(3), (4), or(6)^
3. Name(s) of trustees, directors, partners, officers ofContractor/Organization:S^Ii±_IS.u^^I^5^a^E- Pv\li>-'.»rv VC.AC. T^'IC'-C-'TA'-A-
j4^MMv-.3^^<AV<- ,-Sc.,^<-^ (C£
Pl^iru^-S ^^^sffn '^"s o-<.W<-01
CTC.'S'K«.-
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/Organization:
&-AC &r<s^ ^\C5
Prepared bye
Title: _^^sa
^^^'>*^5Tr^^iA <-
13-
Phone: ~-la^ -y~?/ ~ y7'5^
Date: ^'^S-^^J^
Rev.07.10.2007W.S-X;-':'°'.,;"
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