Orange County NC Website
DocuSign Envelope ID: BOFE06B7-7OC7-44D2-A46C-D41E904EED9B <br /> Contract Number 00041659, Amendment Number 1 / Page 13 of 16 <br /> 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence <br /> the outcome of a covered Federal 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 <br /> the information previously reported, enter the year and quarter in which the change occurred. Enter the date <br /> of the last 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 <br /> known, Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a <br /> prime or sub-award recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime Is the <br /> 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. <br /> 5. If the organization filing the report in Item 4 checks "Subawardee", then enter the full name, address, city, <br /> state and 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 <br /> organizational level below agency name, if known. For example, Department of Transportation, United States <br /> Coast Guard. <br /> 7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the full <br /> Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan <br /> commitments. <br /> 8. Enter the most appropriate Federal Identifying number available for the Federal action identified in Item 1 <br /> (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the <br /> contract grant, or loan award number, the applicationlproposal control number assigned by the Federal <br /> 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, <br /> enter the 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 reporting 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). <br /> Enter Last Name, First Name and Middle Initial(MI). <br /> 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to <br /> the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made <br /> (planned). Check all boxes that apply, If this is a material change report, enter the cumulative amount of <br /> payment made or planned to be made. <br /> 12, Check the appropriate boxes. 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 /> 13. Check the appropriate boxes. Check all boxes that apply. If other, specify nature. <br /> 14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected <br /> to perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time <br /> spent in actual contact with Federal officials. Identify the Federal official(s) or employee(s) contacted or the <br /> off icer(s), employee(s), or Member(s)of Congress that were contacted, <br /> 15, Check whether or not a SF-LLL A Continuation Sheet(s) is attached. <br /> 16. The certifying official shall sign and date the form, print his/her name, title, and telephone number. <br /> 1U <br />