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4 � <br /> 9 <br /> INSTRUCTION FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES <br /> This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of a covered <br /> Federal action,or a material change to a previous filing,pursuant to title 31 U.S.C.section 1352. The filing of a form is required for each payment or <br /> agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of <br /> Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with a covered Federal action. Use the SF- <br /> LLL-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 <br /> material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. <br /> 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered <br /> action. <br /> 2. Identify the status of the covered Federal action. <br /> 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the <br /> information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last <br /> previously submitted report by this reporting entity for this covered Federal action. <br /> 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. <br /> Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward <br /> recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include <br /> but at not limited to subcontracts,subgrants and contract awards under grants. <br /> 5. Of the organization filing the report in item 4 checks "Subawardee", then enter the full name, address, city, state, and <br /> zip code of the prime Federal recipient. Include Congressional District,if known. <br /> 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below <br /> agency name,if known. For example,Department of Transportation, United States Coast Guard. <br /> 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal <br /> Domestic Assistance(CFDA)number for grants, cooperative agreements,loans, and loan commitments. <br /> 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal <br /> (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the <br /> application/proposal control number assigned by the Federal agency). Include prefixes,e.g.,"RFP-DE-90-001." <br /> 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the <br /> Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. <br /> 10. (a) Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the report entity <br /> identified in item 4 to influence the covered Federal action. <br /> (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter <br /> Last Name, First Name,and Middle Initial(Ml). <br /> 1. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying <br /> entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that <br /> apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. <br /> 2. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, <br /> specify the nature and value of the in-kind payment. <br /> 3. Check the appropriate box(es). Check all boxes that apply, If other,specify nature. <br /> 4. Provide a specific and detailed description of the service that the lobbyist has performed,or will be expected to perform, and the <br /> date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact <br /> with Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s),employee(s),or Member(s)of <br /> Congress that were contacted. <br /> 5. Check whether or not a SF-LLL-A Continuation Sheet(s)is attached. <br /> 6. The certifying official shall sign and date the form,print his/her name,title,and telephone number. <br /> Public reporting burden forfhis collection of information is estimated to average 30 minutes per response,including time for reviewing <br /> instructions,searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of <br /> information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for <br /> reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington D.C.20503. <br /> Federal Register/Vol.54,No.243/Wednesday, December 20,1989/Notices 52325 <br /> ADDI Agreement between H - 3 <br /> City of Everett and Snohomish County <br />