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20B - AA - STREET REPAIR
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11/19/2019
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20B - AA - STREET REPAIR
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Last modified
11/14/2019 7:26:22 PM
Creation date
11/12/2019 2:21:44 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20B
Date
11/19/2019
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EXHIBIT 16 <br />FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION <br />Name of Firm: V 1 ph 41MAR2icR 1;'/VP-. Date: 164 <br />Address: <br />State: 44 Zip Code: Telephone: 101-997- 077 <br />Acting on behalf of the above -named firm as its Authorized Official, I make the following Certification to the <br />Department of Housing and Urban Development (HUD) and the Community Development Commission, County of <br />Los Angeles: <br />1) No Federal appropriated funds have been paid, by or on behalf of the above -named firm to any person for <br />influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an <br />officer or employee of C ongress, or an employee of a Member of Congress in connection with the <br />awarding of any Federal contract, the making of any Federal grant, loan, or cooperative agreement, and any <br />extension, continuation, renewal, amendment, or modification thereof; and <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 or any agency, a Member of Congress, an <br />officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal <br />contract, grant, loan, or cooperative agreement, the above -named firm shall complete and submit Standard <br />Form-LLL, "Disclosure Form to Report Lobbying" in accordance with its instructions; and <br />3) The above -named firm shall require that the language of this certification be included in the award <br />documents for all sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, <br />loans, and cooperative agreements) and that all sub -recipients shall certify and disclose 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 the transaction <br />imposed by Section 1352 Title 31 U.S. Code. Any person who fails to file the required certification shall be subject <br />to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. <br />Authorized Official: <br />Name: r/1D> &9M4R1tGF/ Title: <br />/a&Signature: Date: <br />�P <br />/v/3Z 9 <br />F \0OCWROPSVCS%HUDFORMSWBU58WM0 - SecticnMpece. DOC <br />
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