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WRGLOLJHQWO\SHUIRUPLQDFFRUGDQFHZLWKWKHWHUPVDQGFRQGLWLRQVRIWKH$*5((0(17DV HYLGHQFHGE\WKHVLJQDWXUHVEHORZ,QWKHHYHQWRIDQ\LQFRQVLVWHQF\LQLQWHUSUHWLQJWKH GRFXPHQWVZKLFKFRQVWLWXWHWKLV$JUHHPHQWWKHLQFRQVLVWHQF\VKDOOEHUHVROYHGE\JLYLQJ SUHFHGHQFHLQWKHIROORZLQJRUGHURISULRULW\WKHWH[WRIWKLV$JUHHPHQWWKH &2817< 65HTXHVWIRU4XDOLILFDWLRQ³5HDO3URSHUW\2Q&DOO$SSUDLVDO6HUYLFHV´DQG WKH&2175$&725 66WDWHPHQWRI4XDOLILFDWLRQVPDGHLQUHVSRQVHWR&2817< 6 5HTXHVWIRU4XDOLILFDWLRQ³5HDO3URSHUW\2Q&DOO$SSUDLVDO6HUYLFHV´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ounty of Fresno - On-Call Real Property Appraisal Services 2020 Appendix A Page 1 of 3 List of Appraisers The Doré Group, Inc. California Corporation 1010 University Avenue, Suite C207 San Diego, CA 92103 Phone: 619-933-5040 Email: lwdore@thedoregroup.com Manager: Lance W. Doré Key Personnel: Lance W. Doré and Emily Ming. No listed subconsultants. Ellis Group, Inc. dba Integra Realty Resources - Los Angeles California corporation 16030 Ventura Boulevard, Suite 620 Encino, CA 91436-4473 Phone: 818-290-5400 Email: bfinestone@irr.com Manager: Beth B. Finestone, MAI, AI-GRS, FRICS, CRE Key Personnel: Beth B. Finestone, MAI, AI-GRS, FRICS, CRE Beth B. Finestone, MAI, AI-GRS, FRICS, CRE John G. Ellis, MAI, CRE, FRICS Adam M. Bogorad, MAI Robert M. Lea, MAI William Larsen, SR/WA Ryan J. Dobbins Jerardo Arciniega, MAI Nicole B. Galvez Susan O. Gordon Thomas G. Richardson Subconsultants: Integra Realty Resources - Orange County: Beth B. Finestone, MAI, AI-GRS, FRICS, CRE J. Richard Donahue, MAI, FRICS Meredith McDonald Stephanie Kavanaugh Paul Kim Robert Willette, MAI County of Fresno - On-Call Real Property Appraisal Services 2020 Appendix A Page 2 of 3 James G. Palmer Appraisals, Inc. CDOLIRUQLD&orporation 1285 W. Shaw Avenue #108 Fresno, California 93711 Phone: 559.226.5020 Email: gregg@jgpinc.com Manager: Gregg Palmer Key Personnel: Gregg Palmer, Joshua Palmer No listed subconsultants. Cooper & Associates Real Estate Appraisers, Inc. California corporation 2505 W. Shaw Ave., Suite 190, Fresno, CA 93711 Phone: 559-226-5025 Email: cooper.appraisals@sbcglobal.net Manager: Peter T. Cooper, MAI Key Personnel: Peter S. Cooper, MAI; Peter T. Cooper, MAI; Stella Schramm, Office Support No listed subconsultants. rpa Wakefield & Hopper, Inc.; dba REAL PROPERTY ANALYSTS California S-Corp 6730 N. West Ave., #111 Fresno, CA 93711 Phone: 559-261-9136 Email: tkvmach@rpaappraisal.com Manager: Tiffany K. V. Mach Key Personnel: Tiffany K. V. Mach Kelly P. Stevens No listed subconsultants. County of Fresno - On-Call Real Property Appraisal Services 2020 Appendix A Page 3 of 3 Scott Appraisal, Inc. California Corporation 453 Pollasky Ave., #106, Clovis, CA 93612 Phone: 559-324-8221 Email: scott@ScottAppraisal.com Manager: Scott Rurik Key Personnel: Scott Rurik, Chris Preble No listed subconsultants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Local Agency: 2. Contract DBE Goal: 3. Project Description: 4. Project Location: 5. Consultant's Name: 6. Prime Certified DBE: 7. Total Contract Award Amount: 8. Total Dollar Amount for ALL Subconsultants: 9. Total Number of ALL Subconsultants: 10. Description of Work, Service, or Materials Supplied 11. DBE Certification Number 12. DBE Contact Information 13. DBE Dollar Amount Local Agency to Complete this Section 14. TOTAL CLAIMED DBE PARTICIPATION $ 20. Local Agency Contract Number: 21. Federal-Aid Project Number: 22. Contract Execution Date: Local Agency certifies that all DBE certifications are valid and information on this form is complete and accurate. 23. Local Agency Representative's Signature 24. Date 25. Local Agency Representative's Name 26. Phone 27. Local Agency Representative's Title % IMPORTANT: Identify all DBE firms being claimed for credit, regardless of tier. Written confirmation of each listed DBE is required. 15. Preparer's Signature 16. Date 17. Preparer's Name 18. Phone 19. Preparer's Title DISTRIBUTION: 1. Original – Local Agency 2. Copy – Caltrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract execution may result in de-obligation of federal funds on contract. ADA Notice: For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 654- 3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. Page 1 of 2 July 23, 2015 7 9DULRXV (ULQ+DDJHQVRQ 6HQLRU6WDII$QDO\VW &RXQW\RI)UHVQR 2Q&DOO$SSUDLVDO -DPHV*3DOPHU $VVRFLDWHV YDULRXVORFDWLRQV m is complete and accurate. cal Agency Representative's Signature 6/17/20 06/30/2020 559.226.5020Gregg Palmer President County of Fresno Local Assistance Procedures Manual Exhibit 10-O2 Consultant Contract DBE Commitment EXHIBIT 10-O2CONSULTANT CONTRACT DBE COMMITMENT 1. Local Agency: 2. Contract DBE Goal: 3. Project Description: 4. Project Location: 5. Consultant's Name: 6. Prime Certified DBE: 7. Total Contract Award Amount: 8. Total Dollar Amount for ALL Subconsultants: 9. Total Number of ALL Subconsultants: 10. Description of Work, Service, or Materials Supplied 11. DBE Certification Number 12. DBE Contact Information 13. DBE Dollar Amount Local Agency to Complete this Section 14. TOTAL CLAIMED DBE PARTICIPATION $20. Local Agency Contract Number: 21. Federal-Aid Project Number: 22. Contract Execution Date: Local Agency certifies that all DBE certifications are valid and information on this form is complete and accurate. 23. Local Agency Representative's Signature 24. Date 25. Local Agency Representative's Name 26. Phone 27. Local Agency Representative's Title % IMPORTANT: Identify all DBE firms being claimed for credit, regardless of tier. Written confirmation of each listed DBE is required. 15. Preparer's Signature 16. Date 17. Preparer's Name 18. Phone 19. Preparer's Title DISTRIBUTION: 1. Original – Local Agency 2. Copy – Caltrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract execution may result in de-obligation of federal funds on contract. ADA Notice: For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 654- 3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. Page 1 of 2 July 23, 2015 County of Fresno 0% On-Call Appraisal Various PeterS.King ✔$150,000 TBD 0 0 0 Peter S Cooper Digitally signed by Peter S Cooper DN: cn=Peter S Cooper, o, ou, email=cooper.appraisals@sbcgloba l.net, c=US Date: 2020.06.08 09:19:38 -07'00'06/08/2020 Peter S. Cooper, MAI 559-226-5025 Owner 7 9DULRXV Erin Haagenson Digitally signed by Erin Haagenson Date: 2020.07.10 13:56:03 -07'00'7/10/20 Erin M Haagenson 559-600-9908 Senior Staff Analyst 06/08/2020 Peter S. 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3URSHUW\ VKDOO EH GHHPHG WR EH ZLWKLQ WKH MXULVGLFWLRQLIWKHSURSHUW\RUDQ\SDUWRILWLVORFDWHGZLWKLQRUQRWPRUHWKDQWZRPLOHV RXWVLGHWKHERXQGDULHVRI)UHVQR&RXQW\LQFOXGLQJLWVLQFRUSRUDWHGFLWLHVRUZLWKLQ WZRPLOHVRIDQ\ODQGRZQHGRUXVHGE\WKH&RXQW\ Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1.Identify the type of covered federal action for which lobbying activity is or has been secured to influence, the outcome of a covered federal action. 2.Identify the status of the covered federal action. 3.Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4.Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts, subgrants, and contract awards under grants. 5.If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state, and zip code of the prime federal recipient. Include Congressional District, if known. 6.Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7.Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8.Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9.For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10.Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11.Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml). 12.Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 13.Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 14.Check all boxes that apply. If other, specify nature. 15.Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 16.Check whether or not a continuation sheet(s) is attached. 17.The certifying official shall sign and date the form, and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF- LLL-Instructions Rev. 06-04 Page 2 LPP 13-01 May 8, 2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year ____ quarter _________ f. loan insurance date of last report __________ 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier _______ , if known Congressional District, if known Congressional District, if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable ____________________ 8.Federal Action Number, if known:9.Award Amount, if known: 10.Name and Address of Lobby Entity 11.Individuals Performing Services (If individual, last name, first name, MI) (including address if different from No. 10) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 12.Amount of Payment (check all that apply) 14.Type of Payment (check all that apply) $ _____________ actual planned a. retainer b. one-time fee 13.Form of Payment (check all that apply):c. commission a. cash d. contingent fee b. in-kind; specify: nature _______________ e deferred Value _____________ f. other, specify _________________________ 15.Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 12: (attach Continuation Sheet(s) if necessary) 16.Continuation Sheet(s) attached:Yes No 17.Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature: ________________________________________ Print Name: _______________________________________ Title: ____________________________________________ Telephone No.: ____________________ Date:___________ Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard Form LLL Rev. 04-28-06 Distribution: Orig- Local Agency Project Files Page 1 LPP 13-01 May 8, 2013 A Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Public reporting burden for this collection of information is estimated to average 30-minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. 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NONE APPLICABLE - IRR-Los Angeles and it's Subconsultant, IRR-Orange County have never participated in any lobbying activities. Beth B. Finestone Managing Director (818) 290-5400 6//2020 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1.Identify the type of covered federal action for which lobbying activity is or has been secured to influence, the outcome of a covered federal action. 2.Identify the status of the covered federal action. 3.Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4.Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts, subgrants, and contract awards under grants. 5.If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state, and zip code of the prime federal recipient. Include Congressional District, if known. 6.Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7.Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8.Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9.For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10.Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11.Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml). 12.Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 13.Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 14.Check all boxes that apply. If other, specify nature. 15.Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 16.Check whether or not a continuation sheet(s) is attached. 17.The certifying official shall sign and date the form, and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF- LLL-Instructions Rev. 06-04 Page 2 LPP 13-01 May 8, 2013 &RXQW\RI)UHVQR2Q&DOO5HDO3URSHUW\$SSUDLVDO6HUYLFHV$SSHQGL[) Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1.Identify the type of covered federal action for which lobbying activity is or has been secured to influence, the outcome of a covered federal action. 2.Identify the status of the covered federal action. 3.Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4.Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts, subgrants, and contract awards under grants. 5.If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state, and zip code of the prime federal recipient. Include Congressional District, if known. 6.Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7.Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8.Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9.For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10.Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11.Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml). 12.Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 13.Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 14.Check all boxes that apply. If other, specify nature. 15.Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 16.Check whether or not a continuation sheet(s) is attached. 17.The certifying official shall sign and date the form, and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF- LLL-Instructions Rev. 06-04 Page 2 LPP 13-01 May 8, 2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1.Identify the type of covered federal action for which lobbying activity is or has been secured to influence, the outcome of a covered federal action. 2.Identify the status of the covered federal action. 3.Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4.Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts, subgrants, and contract awards under grants. 5.If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state, and zip code of the prime federal recipient. Include Congressional District, if known. 6.Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7.Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8.Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9.For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10.Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11.Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml). 12.Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 13.Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 14.Check all boxes that apply. If other, specify nature. 15.Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 16.Check whether or not a continuation sheet(s) is attached. 17.The certifying official shall sign and date the form, and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30-minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF- LLL-Instructions Rev. 06-04 Page 2 LPP 13-01 May 8, 2013 ŽƵŶƚǇŽĨ&ƌĞƐŶŽͲKŶͲĂůůZĞĂůWƌŽƉĞƌƚǇƉƉƌĂŝƐĂů^ĞƌǀŝĐĞƐϮϬϮϬ SELF-DEALING TRANSACTION DISCLOSURE FORM In order to conduct business with the County of Fresno (hereinafter referred to as “County”), members of a contractor’s board of directors (hereinafter referred to as “County Contractor”), must disclose any self-dealing transactions that they are a party to while providing goods, performing services, or both for the County. A self-dealing transaction is defined below: “A self-dealing transaction means a transaction to which the corporation is a party and in which one or more of its directors has a material financial interest” The definition above will be utilized for purposes of completing this disclosure form. INSTRUCTIONS (1) Enter board member’s name, job title (if applicable), and date this disclosure is being made. (2) Enter the board member’s company/agency name and address. (3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the County. At a minimum, include a description of the following: a. The name of the agency/company with which the corporation has the transaction; and b. The nature of the material financial interest in the Corporation’s transaction that the board member has. (4) Describe in detail why the self-dealing transaction is appropriate based on applicable provisions of the Corporations Code. (5) Form must be signed by the board member that is involved in the self-dealing transaction described in Sections (3) and (4). ƉƉĞŶĚŝǆ' (1) Company Board Member Information: Name: Date: Job Title: (2) Company/Agency Name and Address: (3) Disclosure (Please describe the nature of the self-dealing transaction you are a party to): (4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233 (a): (5) Authorized Signature Signature: Date: ŽƵŶƚǇŽĨ&ƌĞƐŶŽͲKŶͲĂůůZĞĂůWƌŽƉĞƌƚǇƉƉƌĂŝƐĂů^ĞƌǀŝĐĞƐϮϬϮϬ ƉƉĞŶĚŝǆ'