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<br /> , . ~ (l3w <br /> INSTRUCTIONS FOR COMPL:::-nON OF Sr=-111. DISCLOSURE OF LOBBYING ACTIVITIES <br /> This dlsdosurø form snaIl be ccmclsted by the reporting entity. wnather subaward99 oronme Federal racelsnt, at t!"le inltiaIlon cr <br /> n!CSlot ot acwCtf"ed Feaeral ac:Ion. or a matsnaJ c..,ange to a previous tiling. pursuant to tlte 31 U.S.C. sacnon 1352. The tiling of <br /> a torm IS required tor eac.., paymant or agraementto maKe payment to any loobytng entIty tor inrluenc:ng 0 r attempting to int1uenca <br /> an otffcar or employ" ot any agency. a Memcer ot Congl'9ss. an attlcar or 9mcloyeø ot Congress. or an 9m!Jloyee ot a Memoer <br /> at Congress in conn&e:1on with a covered Federal ac:ion. Usa the SF-11 1.A Cont1l'TtJanon Sheet tor aClditiol'1a information it the <br /> spaca on the form is inadequate. Comelete all itams t1'1at apply for both the initial ffling and matenaJ c..,at1ge report. Reter to the <br /> impJ9ment!ng guidance published by the africa at Management and Budget tor additicnaJ intormation. <br /> 1. Identity the type at Covered Federal ad1on tor whicn loòèying activity is andlor has been sacurad to intluencs the our <br /> com. at a covEtf'Ud F9d8raJ adion. <br /> 2. Identity thll statUS at coventd Fed8ra1 acnon. <br /> 3. /d8ntity the appropriate dassffic:ax:1on at tt'lis ntpart. If this is a tollcwup report caused by a rnareria1 change to <br /> tne intol'l'T1a%lon prwviOtJSIy ntpOrt8d. 8tTI:8t'the 'f88r and qua.rt8t" in which the change oC::-.Jrmd. :nter the date <br /> at tt'!elast previously submitted report by tt'IIS t8pomng enrtty TarmlS covered FaderäJ action. <br /> 4. Emerthe fuU narne, address. dty, state and ZIp code at the reporting entity. fndude CongrassionaJ Disnict. <br /> it known. Chedc the appropriate dassitk:a%ion ot the reporting entity that designates it it is. or e:cpec:s to be. <br /> a prime or sucaward recipient. Identify the tier at the sueawardee, e.g.. tne ffrst sucawardH at the prime is <br /> tn. 1 st hr. Subawards indude but are nat limited to suCcontrac:s. subgrants and CQrnract awards under <br /> grants. <br /> 5. Ittne organization tiling tha report in itam 4 checks -Subawarde.., then antenna fuj( nama. address. city, state <br /> and Zip code at the prima Federal recipient. !ndude CangressionaJ OfstJict. it known. <br /> 6. Entarthe name ot the FedaräJ agency making ti. award or/oan commitment. ¡ndude at leas! one <br /> organizational level below agency nam.. if known. Forexampla. Department ot Transportation, United States <br /> Coast Guan:1. <br /> 7. Entert!"le FaderaJ program name or desc:iptlon forth. cov8f8d Fed8ra! adon (itam 1). It known. ¡¡ntartha fuJl <br /> Cëta.loc¡ at Fed81õ1J DomeStic Assistanca (CFOA) numi2.rtor grants. cooperative agreements. loans. and <br /> loan commitmentS. . <br /> S. Entørthe most appropriate FederaJ id.ntlfying nu~r awilabi. torthe FecteraJ aden identitfed in item 1 (e.g.. <br /> Request tor Proposai (RFP) numèer. fnvit~ tor Bid (IFa) numD8r, grant announcamant nurnesr. the <br /> ~ grant. or loan award number, t1'1e ~lcation/ptOpOSal COntr1:U numb.r assigned by the HtderaJ <br /> 3qency). Include prefix... ..goo "'AFP-OE-90-001.. <br /> 9. For a coverwd ¡:.a.raJ ac:tJon wn.... thltfW /'1as been an award or loan commitment by t!"le F9daraJ agency. entar <br /> tne Federal amount ot the awardItoan commitment tortt'l. prim8 enttty identIfied in Item 4. or 50 <br /> 10. (a) Entertne tuU name. addnJ.ss. city, stat. and Zip cod8 attneloèCying entity engaged by the reporting entity <br /> identifled in it.m 4 tQ intlu.nea the covet8d F«i8rai aC:fon. <br /> (b) Ent8f"the fuit na1T'188 at tne indMdual(s) performing s.Mces. anáinduda full addr9ss it diffantnt from 10 <br /> (a). Enter Last Name. First Name, and Mlddl. Initjaj (MI). <br /> 11. EntMtt'I. amount at compensation paid orl"8uonaCiy .xpectød to be paid by the repomng amity (item 4) to t!"le (obeying <br /> entity (item 10). fndfca%e whethertne payment has aeen made (adUai) orwíil be made (planned). Chad< all boxes t!"lat <br /> apply. If this is a mat9naJ d1ange report. 9nt8t'th. cumulativ. amount at payment made orp anned to be made. <br /> 12. Ched<tt'leappro;:lriatebox(es). Ched< all baxestMatWy. If payment is mada through at1 in-kíndc::ntnbunon. speer¡ t!"le <br /> natUre and vajue at the in-kind payment. <br /> 1:l. Ched< tn. appropriate box(es). Ch8d< ~ box.s mar appiy. It other. specíty natura. <br /> 14. Provide a spec::tfc and detailed description at the s.rvic:as that the lobbyist has performed. arwifl be expected to perform. <br /> and tn. date(s) ot êl1Y :58fVicas rendered./ndUda aU preparatory and reWed ac:ivity, not just time ~pent in ac:ua1 c::ntac: <br /> with Fed.raJofflciaJs./dønIffythe FødaraJ ottfciat(S)oremployee(s) COntaded ortn8 off!car(s), eJ"M!:'foyee(s), or Memcer(s) <br /> at Congress that we,.. contëctðd <br /> 1 S. Ched< whether or not a SF-111.A Continuation Sh88t(s) is attad'l8d. <br /> 16. The C8mtying offlciai shaH sign and date me torm. ¡:mnt nislh8rname. title. and te ep/"lone nurneer. <br /> ï"uoIic: r8OOrI3n9 ~ tor ~ c:ca.cacn 01 ~ IS .411.. _;I Ia ~ jQ - .,.,. -. t--.q ttm'8 'or (~It'ISInJQQ'IS. seercnonq '¡JDSCt'9 <br /> .- --. ~ - ~ q,. d8ra -eGo ò1I1C! ~ - t-'9 a'Ie ~ at~. s~ CO'M"8t'tS ~ q,. our-=- oKa.....x. <br /> or any 0InW UO8C% at tnlS CQlIec::oft at .. .100. .1-.... ~ SUÇQ8AOftS lOt' ~q au OUf'I38'. = aw O'IIca at Matlaq..noMt ò1I1C! ~ P- Reau= <br /> ~ (Q~. °Nul1l~, O.Co :zt ~ <br />