Pasadena_Taxpayer_Protection_Amendment_Disclosure_(2).pdf

PDF 472 KB Posted

Attached to
Safe Speed Campaign
Solicitation number
2022-RFP-228
Issued by
Los Angeles County, California

About this file

This document is a Disclosure Form pursuant to the City of Pasadena Taxpayer Protection Amendment under the Pasadena City Charter, Article XVII. The form requires contractors or organizations to provide transparency about their organizational structure by disclosing trustees, directors, partners, officers, and individuals with more than 10% equity, participation, or revenue interest. The form includes designated sections for the contractor/organization name, type of entity (with checkboxes for non-government and nonprofit 501(c)(3), (4), or (6) options), names of key organizational leaders, and individuals with significant financial stakes.

The disclosure form is specifically related to the City of Pasadena's Safe Speed Campaign, a grant-funded pedestrian and bicyclist safety program supported by the California Office of Traffic Safety through the National Highway Traffic Safety Administration. The form serves as a mechanism for ensuring accountability and transparency for potential contractors involved in the safety campaign, requiring detailed information about the organizational leadership and ownership structure. While the form itself does not specify financial terms or specific contract details, it is a prerequisite documentation requirement for organizations seeking to participate in the city's safety initiative.

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Text version

{project.template.processClassification} - {project.title} Release Date: {project.releaseProjectDate}

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:

2. Type of Entity:

□ non-government □ nonprofit 501(c)(3), (4), or (6)

3. Name(s) of trustees, directors, partners, officers of Contractor/Organization:

4. Names of those with more than 10% equity, participation or revenue interest in Contractor/Organization:

Prepared by: ________________________________

Title: ______________________________________

Phone:

Date: ______________________________________

File details come from the government source that posted it. Updated .