Laserfiche WebLink
Certification Regarding Lobbying for <br />Contracts, Grants, Loans, and Cooperative Agreements <br />The undersigned <br />of certifies, to the best of <br />its knowledge and belief, that: <br />1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, <br />to any person for influencing or attempting to influence an officer or employee of an agency, a <br />Member of Congress, an officer or employee of Congress, or an employee of a Member of <br />Congress in connection with the awarding of any Federal contract, the making of any Federal grant, <br />the making of any Federal loan, the entering into of any cooperative agreement, and the extension, <br />continuation, renewal, amendment, or modification of an Federal contract, grant, loan or <br />cooperative agreement. <br />2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for <br />influencing or attempting to influence an officer or employee of any agency, a Member of Congress, <br />an officer or employee of congress, or an employee of a Member of Congress in connection with <br />this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and <br />submit Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its <br />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 under <br />grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose <br />accordingly. <br />This certification is a material representation of fact upon which reliance was placed when this transaction was <br />made or entered into. Submission of 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 fails to file the required certification <br />shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. <br />Signed: <br />Title: <br />Date: <br />26 <br />