2005-144 - Laserfiche WebLink

Home Browse Search

DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U .S . C . 1352 0348-0046 (See reverse for public burden disclosure . 1 . Type of Federal Action : 2 . Status of Federal Action : 3 . Report Type : f b J a . contract [ b ] a . bid/offer/application f b J a . initial filing l 1 b . grant b . initial award l J b . material change c . cooperative agreement c . post-award For Material Change Only : - d . loan year quarter e . loan guarantee date of last report f. loan insurance 4. Name and Address of Reporting Entity : 5, If Reporting Entity in No . 4 is a Subawardee, Enter Name Q Prime ❑ subawardee and Address of Prime: Tier if known : . COUNTY DOES NOT ENGAGE IN LOBBYING ACTIVITY 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 . a. Name and Address of Lobbying Registrant b . Individuals Performing Services ( including address if ( if individual, last name, first name, Ml ) : different from No. 10a ) ( last name, first name, M/ ) : NONE NONE 11 , Information requested through this form is authorized by title 31 U.S.C. section Signature : 1352. This disclosure of lobbying activities is a material representation of fact r upon which reliance was placed by the tier above when this transaction was made Print Name : COMMISSIONER TOM LOWTHER or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be available for public inspection_ Any person who fails to file the INDIAN RIVER CO. BOARD OF COUNTY COMMISSIONERS required disclosure shall be subject to a civil penalty of not less than $10,000 and Title : not more than $100.000 for each such failure. 772 -567-8000 5 / 3 / 2005 Telephone No . : Date: Federal Use Only: Authorized for Local Reproduction Standard Form LLL (Rev. 7-97)