Pasadena_Taxpayer_Protection_Amendment_Disclosure_(2).pdf

PDF 472 KB Posted

Attached to
San Rafael Bridge Seismic Retrofit (BHLS-5064(101))
Solicitation number
2024-RFP-0637
Issued by
Los Angeles County, California

About this file

This document is a Disclosure Form for the City of Pasadena Taxpayer Protection Amendment, specifically related to Pasadena City Charter, Article XVII. The form requires a contractor or organization to provide detailed transparency about their organizational structure by disclosing key personnel and ownership information.

The disclosure form is designed to capture critical organizational details, including the contractor's name, type of entity (with options for non-government or nonprofit 501(c)(3), (4), or (6)), and comprehensive information about trustees, directors, partners, officers, and individuals with more than 10% equity, participation, or revenue interest. The document provides blank spaces for the contractor to fill in these details, with instructions to print legibly and use additional sheets if necessary. At the bottom of the form, there are fields for the preparer's information, including name, title, phone number, and date of preparation.

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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 .