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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 17-6897 <br />FLOWER STREET BIKEWAY <br />FEDERAL PROJECT NO: HSIPL 5063 (187) <br />dapadment oragoncy with which this transactor, A inafed <br />may pursue available remedus, including suspension andta <br />debarment. <br />CargNcatlon Regarding Debarment, Suspension, <br />Noligibility and Voluntary Exclusion -Lower Tier <br />Participants: <br />1. The prospectvo lower gorpadicipari coripos, by <br />submission of this proposal, that refhari merits pdrelpals Is <br />prosentty debanod, suspended, proposed for debarment. <br />declared oelgUlo a voluntarily excluded from participating in <br />covered transactions; by any Federal department a agency. <br />2. Where the prospective borer gar participant is unable to <br />carlfy b any of the statements In this radtication, such <br />prospectba participant shal attach an expianatlen to M <br />pmposal. <br />XI. CERTIFICATION REGARDING USE OF CONTRACT <br />FUNDS FOR LOBBYING <br />This provision is sppgmbo Just]Fademlaid construction <br />contracts ardto all misled subcontracts which exceed <br />$100,000 (49 CFR 20). <br />1. The prospective porWicant certifies, by signing and <br />submitting this bid or proposal, to the best of He or her <br />knowledge andbele4 that: <br />a. No Federal appropriated funds have been paid or will be <br />paid, by or on behalf of the undersigned, to cry parson for <br />Influencing or attempting to influence an officer or employee of <br />any Federal agency, a Member of Congress, an officer or <br />ar poyee of Congress, or an employee of a Member of <br />Congress in canedon wish the avadig of any Federal <br />contract, the ma" of any Federal grart, the molding of any <br />Federml Iron, the entering ido of any cooperative agrearnenl. <br />and One extension, continuation, renewal, anencmenb or <br />modifkationof any Federal contract, grant, loan, or <br />cooperagvealimemart. <br />b. f any funds other than Federal appropriated funds have <br />been paid or vA be paid to any person for influencing a <br />attempting to influence an officer a employee of any Federal <br />agency, a Member of Cbngmss, an offices a employee of <br />Congress, or as employee of a Merrbar of Congress in <br />connection with this Federal contact, grant, kiss, or <br />cooperative agmemort, the undersigned shal complete acl <br />submit Standard FOmnLLL, 'Disclosure Fomn to Report <br />Lobbying.' in accordaree With its iuhuctms. <br />2. This cerlTiralbn is a material representation of fad upon <br />which refanco was placed when this transaction was made a <br />artenadirto. Submissbnofthi3ca0fmgonisapremgtisbe <br />for matting or entering into this transaction imposed by 31 <br />U.S.C. 1352 Any prim whofails to No the requited <br />wdlgcaton shal be sujact to a rid penalty of not less than <br />$%000 and net mora than $100.000 for each such failure. <br />3. The pmspective participant also agmes by submitting its <br />bid or proposal list the padoy:ari shall mquie that the <br />Language of this certification be included in all borer her <br />subcontracts, which exceed $100,000 and that all such <br />reciports shal cerfrfy ant disclose accordingly. <br />P-29 of P-52 <br />