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CERTIFICATION REGARDING LOBBYING FOR <br />CONTRACTS, GRANTS, LOANS, <br />AND COOPERATIVE AGREEMENTS <br />The undersigned <br />best of its knowiedge and belief, that: <br />certifies, to the <br />No federal appropriated funds have been paid or will be paid, by or on behalf of the <br />undersigned, to any person for influencing or attempting to influence an officer or employee <br />of an agency, a member of Congress, an officer or employee of congress, or an employee of <br />a member of Congress in connection with the awarding of any federal contract, the making <br />of any federal grant, the making of any federal loan, the entering into of any cooperative <br />agreement, and the extension, continuation, renewal, amendment, or modification of any <br />federal contract, grant, loan, or cooperative agreement. <br />2. If any funds other than federal appropriated funds have been paid or will be paid to any <br />person for influencing or attempting to influence an officer or empfoyee of any agency, a <br />member of Congress, an officer or employee of Congress, or an employee of a member of <br />Congress in connection with this federal contract, grant, loan, or cooperative agreement, the <br />undersigned shall complete and submit standard form - III, "Disclosure Form to Report <br />Lobbying", in accordance with its instructions. <br />3. The undersigned shall require that the language of this certification be included in the award <br />documents for all subawards at all tiers (including subcontracts, subgrants, and contracts <br />under grants, loans, and cooperative agreements) and that all subrecipients shall certify and <br />disclose accordingly. <br />This certification is a material representation of fact which reliance was placed when this transaction <br />was made or entered into. Submission of this certification is a prerequisite for making or entering <br />into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the <br />required certification shall be subject to a civil penalty of not less than $10,000 and not more than <br />$100,000 for each such failure. <br />Signed: <br />Name <br />Mayor <br />Date: <br />2010 Main Street Application Page 14 of 30 2-5-10 <br />- i n o <br />