2021/07/28 Council Agenda Packet

DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure.) Approved by OMB 0348-0046 1 Type of Federal Action: 2. Status of Federal Action: 3. Report Type: B I a. contract I A la. bid/offer/application I A a. initial filing b. material change For Material Change Only: year quarter b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance b. initial award c. post -award date of last report 4. Name and Address ■ Prime of ■ Reporting Entity: Subawardee Tier , if known: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime: Congressional District, if known: City of Everett 2930 Wetmore Ave Everett, WA 98201-4067 Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: U.S. DOJ Officer of Justice Programs 8. Federal Action Number, if known: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Registrant (if individual. last name. first name. MI): b. Individuals Performing Services (including address if different from No. 10a ) N/A (last name. first name. MI): N/A 11. Information requested through this form is authorized by title 31 U.S.C. section fact Signature: 1352. This disclosure of lobbying activities is a material representation of upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required to 31 U.S.C. 1352. This Print Name: - pursuant information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be Title: Mayor subject to a civil penalty of not less that $10,000 and not more than $100,000 for each such failure. Telephone No.: (425) 257-7112 Date: Federal Use Only: Authorized for Local Reproduction Standard Form LLL (Rev. 7-97)