HomeMy WebLinkAboutExhibit 5Approved by OMi!
•ATTACHMENT B �4
DISCLOSURE OF LOBBYING ACTIVITIES
Complete this fens to disclose lobbyism activities pursuant to 3Z U.S.C. 1332
(Sas reverse for public burden disclaims.)
a. Type of Federal Actions
a. comma
b. grant
c. cooporadvs apeman
d.laa
e. lass pantos,*
f Imo iusvtaace
2. Status of Federal Actions
i bidrofferlappmadon
b. kids! award
c. pat4award
3.. Report Types
a. Initial AIN
b. material Map
For Material Change Onlyt
year quartet
dated lest report `w
4 Naafis and Address of Reporting Lonny:
❑ Rims ❑ Subev ardee
Tier --�w .. rwrown.'
Corsmrvesionul District, Vkaer'e:
di. Federal DspareoosavAgeocyr
S. u licrorting Entity in No. die Subewardes, Enter Nacos
:, sikdd,yW otlrim.r a.. .. .
Congresiloaal District, if Mown:
11. Federal Action !lumber, (thaw
7. Federal Progress NamoiDesceiptlos: .
CPDA Number, flappkra*ts:
10: I. NSW and Address of Lobbyism Entity
a 1' individual. Iasi name.Ar r name, MO:
S. Award Amount, V known:
b. individuals Performing Services (iaelialing Wren i( Aroma from
plan none. Ara, .oaw, Af11:
. Iaieoeh.Caalearadrin Shssr(s1 .03,144. a!aerasn y)
11. taiwaitiaa regianst 6,,1 i IMi :files 1.:i14e,lir+ b Mk ii v ti.c.
midis 13:11, •,TWI •dtiiir+.sNra 'of ht'ri ,:ail IIw Y air saaisrirt
nawitseltellea. of lies uJ '. felllbn.:we: b'M,s sir■. iben
' wbeeiflOS4 44:--N i . + 1.,ei 1,W
pass t e 31 CSC. ydi' T`h . •
! 1�'t irlid• is Ci�gnss
sumInasaally bed wIU is kwpabil A per>se wbp
tall: to till the rNeind li elves Ad be is trdvil mishy rf sot
Mn theses 11 eat en teen OM 1144401 M sash sae! min
Fedaratthe
.
Signature:
Print Nunes
Titbit
• Telephone No. pops
Authorised b local Reprodreiss
:e04a1d Para- ILL fMv, i -1171
Form DEP 55-221(01W7 )