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HomeMy WebLinkAboutForm 602 07/20/2017Lobbying Firm Activity Authorization (Government Code Section 86104) Check one box, if applicable Lobbyist Employer (Gov. Code Section 820395) Lobbying Coalition (FPPC Regulation 18616.4) Type or Print in Ink HAIVM OF FILER: City of Seal Beach 211 8th Street Seal Beach I hereby authorize 2017 -2018 (Insert Years) Page 1 of _ (state) (zip C CA 90740 Townsend Public Affairs, Inc. (Name of Lobbying Firm) 1401 Dove Street, Suite 330, Newport Beach, CA 92660 (Business Address) N For Official Use Only 562 , 431 -2527 to engage in the activities of a lobbying firm (as de£med in California Government Code Section 82038.5 and 2 Cal. Code of Regs. Section 18238.5) on behalf of the above named employer. If you are authorizing another lobbying firm to 106y on behalf of your firm's client(s), provide the name(s) of the client(s) below. (It is not necessary to complete the Nature and Interests section.) VERIFICATION I have used all reasonable diligence in preparing this Statement. I have reviewed this Statement 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. Executed on av n By ` DATE SIGNATURE OF RESPO I LE OFFICER 111� Name of Responsible Officer�l.� � ' I Title PRINT OkJPE FPPC Form 602 (7/96) For Technical Assistance: 916/322 -5660 Lobbying Firm Activity Authorization SEE INSTRUCTIONS ON REVERSE Type or Print in Ink NAME OF FILER: City of Seal Beach Page 2 or 2 Nature and Interests of Lobbyist Employer Check one box only: ❑ INDIVIDUAL (Complete ❑ BUSINESS ENTITY ❑INDUSTRY, TRADE OR MOTHER (e.g., lobbying only Pats A and E) (Complete only Puts B PROFESSIONAL ASSN. coalition) (Complete only and E) (Complete only Puts C and E) Parts D and E) A. Individual : 2. Description of business activity in which you or your employer are 1. Name and address of employer (or principal place of business if engaged: self -employed): _ B. Business Entity Description of business activity in which engaged: C. Industry, Trade or Professional Association : 2. Specific description of any portion or faction of the industry, trade, or 1. Description of industry, trade or profession which the association exlusively or primarily represents: p " try, profession represcnted: , ................................................................ ............................... ............................................................ ............................... 3. Number of members in association (check appropriate box) ❑ 50 OR LESS (provide names of all members on an attachment.) ❑ MORE THAN 50 D. Other i 2. Description of any trade, profession, or other group with a common 1. Statement of nature and purposes: economic interest which is principally represented or from which membership or financial support is principally derived: Municipal Government E. Industry Group Classification Check one box which most accurately describes the industry group which you represent. See instructions on reverse. ❑ AGRICULTURE ❑ EDUCATION ❑ GOVERNMENT ❑ HEALTH ❑ LEGAL ❑ PUBLIC E,IIPLOYEES ❑ POLITICAL ORGANIZATIONS ❑ UTILITIES ❑ LABOR UNIONS ❑ OTHER.- (Describe in detail) BUSINESS (Check one of the following sub - categories.) ❑ ENTERT AINMENT/RFCREATION ❑FINANCE/INSURANCE ❑ LODGING/RESTAURANPS ❑ NIANU FACTURING/IND USTRIAL ❑ MERCHANDISFJRETAIL ❑ OIL AND GAS ❑ PROFESSIONAL/I'RADE ❑ REAL ESTATE ❑ TRANSPORTATION ❑ OTHER: (Specific Description) FPPC Form 602 (7/98) For Technical Assistance: 9161322 -5660