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CSJ # <br />District # <br />Code Chart 64 # <br />Project: <br />CFDA # <br />contract to certify its eligibility to receive Federal funds and, when <br />State, to furnish a copy of the certification. <br />requested by the <br />28. Lobbying Certification <br />In executing this Agreement, the signatories certify to the best of his or her knowledge <br />and belief, that: <br />A. No federal appropriated funds have been paid or will be paid by or on behalf of the <br />parties to any person for influencing or attempting to influence an officer or employee <br />of any federal agency, a Member of Congress, an officer or employee of Congress, <br />or an employee of a Member of Congress in connection with the awarding of any <br />federal contract, the making of any federal grant, the making of any federal loan, the <br />entering into of any cooperative agreement, and the extension, continuation, <br />renewal, amendment, or modification of any federal contract, grant, loan, or <br />cooperative agreement. <br />B. If any funds other than federal appropriated funds have been paid or will be paid to <br />any person for influencing or attempting to influence an officer or employee of any <br />agency, a Member of Congress, an officer or employee of Congress, or an employee <br />of a Member of Congress in connection with federal contracts, grants, loans, or <br />cooperative agreements, the signatory for the Local Government shall complete and <br />submit the federal Standard Form-LLL, "Disclosure Form to Report Lobbying," in <br />accordance with its instructions. <br />C. The parties shall require that the language of this certification be included in the <br />award documents for all subawards at all tiers (including subcontracts, subgrants, <br />and contracts under grants, loans, and cooperative agreements) and that all <br />subrecipients shall certify and disclose accordingly. <br />Submission of this certification is a prerequisite imposed by Title 31 U.S.C. §1352 for <br />making or entering into this transaction. Any person who fails to file the required <br />certification shall be subject to a civil penalty of not less than $10,000 and not more <br />than $100,000 for each such failure. <br />29. Insurance <br />If this agreement authorizes the Local Government or its contractor to perform any work <br />on State right of way, before beginning work the entity performing the work shall provide <br />the State with a fully executed copy of the State's Form 1560 Certificate of Insurance <br />verifying the existence of coverage in the amounts and types specified on the Certificate <br />of Insurance for all persons and entities working on State right of way. This coverage <br />shall be maintained until all work on the State right of way is complete. If coverage is <br />not maintained, all work on State right of way shall cease immediately, and the State <br />may recover damages and all costs of completing the work. <br />30. Signatory Warranty <br />The signatories to this Agreement warrant that each has the authority to enter into this <br />Agreement on behalf of the party represented. <br />IN TESTIMONY HEREOF, the parties hereto have caused these presents to be executed in <br />duplicate counterparts. <br />AFA_AFA_SafeRts2School Page 13 of 14 07/07/10 <br />