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City of Santa Ana <br />ATTACHMENT E: <br />NON -LOBBYING CERTIFICATION <br />The prospective participant certifies, by signing and submitting this bid or proposal, to the best <br />of his or her knowledge and belief, that: <br />(1) 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 <br />employee of any Federal agency, a Member of Congress, an officer or employee of <br />Congress, or an employee of a Member of Congress in connection with the awarding of <br />any Federal contract, the making of any Federal grant, the making of any Federal loan, <br />the entering into of any cooperative agreement, and the extension, continuation, <br />renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative <br />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 employee of any Federal <br />agency, a Member of Congress, an officer or employee of Congress, or an employee of <br />a Member of Congress in connection with this Federal contract, grant, loan, or <br />cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, <br />"Disclosure of Lobbying Activities," in conformance with its instructions. <br />This certification is a material representation of fact upon which reliance was placed when this <br />transaction was made or entered into. Submission of this certification is a prerequisite for <br />making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any <br />person who fails to file the required certification shall be subject to a civil penalty of not less than <br />$10,000 and not more than $100,000 for each such failure. <br />The prospective participant also agrees by submitting his or her bid or proposal that he or she <br />shall require that the language of this certification be included in all lower tier subcontracts, <br />which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. <br />Signed: <br />Title: <br />Firm: <br />Date: <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />City of Santa Ana Page 144 <br />Ambulance & Paramedic and Collection Services <br />Request for Proposals: # 19-083 <br />September 13, 2019 <br />25B-67 <br />