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/Organizatioa Name:
Coc^^f\C^ ^^.'p/n&n4
2. Type of Entity:
^on-govemment D nonprofit 501(c)(3), (4), or (6)
3. Name(s)j)f trustees, directors,partners, officers of Contractor/Organization:
Ve.\}iir\ N^C-vx ^-\
^r^^^i^i t<^v^fA\^
^NJe^x'u
4. Names of those with more than a 10% equity, participation or revenue interest in Contractor/Organization:
^C-f\ji^ AJ^u-eVl
'^v^(U^ r^^.i^x.^1/\-^3J-e.\ ^J'fL^t-1^
Prepared by: l3r<jAtKV ^^tll
MiOL ^li^-FTitle:
Phone:<?1/'? 46-b-?66?
Date: ^/3 1/7^
Rev.07.10.2007