Office of the City Auditor 1221 SW 4th Ave Room 320 Portland, OR 97204
AUD 212-B (01/06)
Phone: 503-823-4078 www.portlandregon.gov/auditor
Code Section 2.12.040
City of Portland Lobbying Entity Quarterly Statement
September 30 2009
1. Lobbying Entity Information
3181 SW Sam Jackson Park Road, L101
Portland , OR 97239
2. Lobbying Exemption
I affirm that for the reporting quarter, this lobbying entity has spent less than 8 hours and less than $1,000 lobbying. No reports are required.
(List the specific subject(s) of the official action of interest to the lobbying entity; the names of City officials contacted by the lobbying entity through direct mail, email or telephone and the names of City officials with whom the lobbying entity met regarding such subject or subjects and the dates of the contact or meetings.)
Action of Interest
4. Certificate of Limited Expenditures
You DO NOT have a current Certificate of Limited Expenditures on file indicating that you do not anticipate spending over $1,000 per calendar quarter lobbying.
List the total amount of all moneys (if the total exceeds $1,000.00) expended by the lobbying entity or any lobbyist employed by or otherwise authorized to lobby on behalf of the lobbying entity, for the purpose of lobbying City officials on behalf of the lobbying entity in the preceding calendar quarter. The types of expenses to be included are: Food, refreshments, travel, entertainment, printing, postage, telephone, advertising, direct mail, e-mail, miscellaneous items, gifts, compensation paid to lobbyists and reimbursements to lobbyists for their expenses.
Per City Code Section 2.12.040 B:
The following expenditures are not required to be included on this statement: personal living, travel expenses, and office overhead, including salaries and wages paid for staff providing clerical assistance and others not engaged in lobbying activities, and maintenance expenses.
If the amount of an expenditure required to be included in this statement is not accurately known at the time the statement is required to be filed, an estimate of the expenditure shall be submitted in the statement and designated as an estimate. The exact amount expended for which a previous estimate was made shall be submitted in a subsequent amended report.
6. City Officials benefitted
List below the name of any City official to whom or for whose benefit, on any one occasion, the lobbying entity made an expenditure in excess of $25 in the preceding calendar quarter for the purposes of lobbying and the date, name of payee, purpose and amount of that expenditure.
7. Notice of expense provided by lobbyist
A copy of any notice provided to a City official under ORS 244.100 shall be attached to this form.
By signing this document, I acknowledge and affirm under the penalties of false swearing the statements made on this form and that I understand that penalties may be imposed under City Code Chapter 2.12.
Lobbying Entity Official signature ____________________________ Date _____________
To complete this form, please sign and date this statement. Email as PDF to firstname.lastname@example.org or mail the signed statement to:
City of Portland
Office of the City Auditor
1221 SW 4th Avenue Room 320
Portland, OR 97204