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ThepmspeoUve participant certifies, by signing and submitting this bid or proposal, to the beat of his or <br />knowledge and belief, that; <br />L No Weral oppropdated funds have bean paid or will bepaid, by or on behalf oftho undersigned, to <br />any person for influencing or attempting to influence an officer or employee of any federal agency, a <br />Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress <br />In connection with the awarding ofany federal contract, the making of any federal grant, the making <br />of any federal loan, the entering into of my cooperative agrcement, and the ostenslon, continuation, <br />renewal, amendment, or modification of any federal oontract, grant, loan, or cooperative agreement, <br />2, if say fiords other than federal appropriated funds have been paid or wilt be paid to anyporson for <br />Influencing or attempting to influence any officer or employee of my federal agency, aMember of <br />Congress, an officer oromployee of Congress, or an employee of a Member of Congress in <br />connection with this federal contract, gram loan, loan or cooperative agreement, the undersigned <br />sballcomplete and submit a "Disclosure of Lobbying Aotivities", <br />was <br />by scetian <br />a civil <br />The prospective pardclpaut also agrees by submitting his or herbid orproposal that he or she shall require thatthe <br />language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub <br />recipients shall certify and disclose arcoordingly, <br />Signed and Printed Name: <br />Title re cri <br />Date L i GV1 i-3tom, OrW 1 y <br />c ..a«?� w. �',e.'m..� ��.... ,�,.U. .ke �., a�//,;nr x��'ztn �a.w....d si`�.... •!_�. _.t,....�_ � r� a�.Y,ti'�'�a <br />Wage <br />