Disclosure Pursuant to the
City of Pasadena Taxpayer Protection Amendment
Pasadena City Charter, Article XVU
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. Cqntraqtpr/Qrganization Nam^:^qntraqtpr/Qrganization Nam^:
>r:M°<^^ M^^^ T^t..
2. Type of Entity:
non-govemment a nonprofit 501(c)(3), (4), or (6)
3. Name(s) of trustees, directors, partners, officers ofContractor/Organization:
C^ns-\<:,^i-^ ^^vn) ^ ^r.^^^-
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/Organization:
^^^^F^- ^^i^TT
Prepared by: C^V^S ^ S?l,-7)
Title: Pr^<^L^
'^3~
Phone: -Z^-L M». O^'^-
Date:v2-( ^(^2..^
Rev.07.10.2007