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<br />. . ~ . ~. <br /> <br />C_fTF!CATTON REGARDING LOBBYING <br /> <br />CERTIFICATION FOR CONTRACTS. GRANTS, LOANS ANO COOPERATIVE AGREEMENTS <br /> <br />The undersigned certifies, to the best of his or her knowledge and belief <br />that: <br /> <br />(1) No federal appropriated funds have been paid or will be paid, by <br />or on behalf of the undersigned, to any person for influencing or <br />attempting to influence an officer or an employee of any agency, <br />a member of congress, an officer or employee of congress. or an <br />employee of a member of congress in connectian with the awarding <br />of any federal contract, the making of any federal grant, the <br />making of any federal loan, the entering into of any cooperative <br />agreement, and the extension, continuation, renewal, amendment, <br />ar madification of any federal contract, grant, loan, or <br />cooperative agreement. <br /> <br />(2) If any funds other than federal appropriated funds have been paid <br />or will be paid to any person for influencing or attempting to <br />influence an officer or employee of any agency, a member of <br />congress, an officer or employee of congress, or an employee of a <br />member af congress in connection with this federal contract, <br />grant. loan, or cooperative agreement, the undersigned shall <br />camplete and submit Standard Form-lll, "Disclosure Form to Report <br />Lobbying, II in accordance with its instructions. <br /> <br />'. <br /> <br />(3) The undersigned shall require that the language of this <br />certification be included in the award dacuments far all <br />subawards at all tiers (including subcontracts, sub grants , and <br />contracts under grants, laans and cooperative agreements) and <br />that all subrecipients: shall certify and disclose accordingly. <br /> <br />This certification is a material representation of fact upan which reliance <br />was placed when this transaction was made or entered into. Submissian of <br />this certification is a prerequisite for making or entering into this <br />transaction imposed by Section 1352, Title 31, U.S. Code. Any person who <br />fails to file the required certification shall be subject to a civil <br />penalty of not less than S10.000 and nat more than S100,000 for each such <br />failure. <br /> <br /> <br />Y_.2f-1C <br />Date <br /> <br />~& cJl) ;JC).1J0 7 17 - () I <br />Application or Contract Number <br /> <br />AJ^/5 - ~l1lnl1r a. ;4'J;//i <br />Name and Ad ress OT Organizat1on <br /> <br />LJ.-~ <br />I <br /> <br />, r~. ~.: <br />