Lobbyist_2019_I & S1_Ugarte & Associates LLC_120519 i
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OFFICE OF THE (;
City Clerk of Long Beach
LOBBYIST REGISTRATION & REPORTING FORM
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SECTION II
❑ I certify that I have been authorized by the Lobbyist identified above to make this verification. I have reviewed the requirements of the
provision of the Long Beach Municipal Code(LBMC Chapter 2.08-Lobb fists). I certify under penalty of perjury under the laws of the
State of California that I have reviewed this Termination and to the best of my knowledge the information contained herein is true and
complete.
Print Name: Title: j
Signature: Date:
SELECT ALL THAT ARE APPLICABLE
Registration Registration Reduced Fee Registration Fee for Additional Registration Late
Fee$115/Year $58/Year Clients$28/Client Fee$29.05/Day
® ❑
Total $ 0,00
Lobbyists Fees are subject to change on a quarterly basis. Please see the Current Fee Schedule to apply the correct fees.
MAKE CHECKS PAYABLE TO:
CITY OF LONG BEACH
FORMS AND PAYMENT CAN BE SENT TO:
CITY OF LONG BEACH -C/O OFFICE OF THE CITY CLERK
333 WEST OCEAN BLVD. - LOBBY LEVEL- LONG BEACH, CA 90802
NOTE: Late fees will apply to any lobbying activity not reported after the 15 days of qualifying as a lobbyist
I have reviewed the lobbyist guidelines and I have nothing to report. I have indicated as such in SECTION III for this period.
Attached to this report is SECTION III,which lists the current activity for this period.
MANNIMM
I have used all reasonable diligence in preparing this report. I have reviewed all the sections and to the best of my knowledge
the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of
California that the foregoing is true and correct.
Print Name: 00 S�L V - t�U 1Title:
Signature: Date: 1
Updated 9/25/2019 LOBBYIST REGISTRATION&REPORTING FORM
City Clerk of Long Beach
LOBBYIST REGISTRATION & REPORTING FORM
Page 3 of 3
SECTION III I have reviewed the lobbyist guidelines and I have nothing to report.
Client Name Client Address Client Phone Lobbyist(s) Item(s) Discussed City Contact(s)
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