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The undersigned certifies, to the best of his or her <br />1) No Federal appropriated funds have been paid or will <br />the undersigned, to any person for influencing or after <br />officer or employee of any agency, a Member of Cone <br />awarding of any Federal contract, the making of any f <br />any Federal loan, the entering into of any cooperative <br />extension, continuation, renewal, amendment, or mod <br />contract, grant, loan, or cooperative agreement. <br />2) If any funds other than Federal appropriated funds hav <br />to any person for influencing or attempting to influence <br />any agency, a Member of Congress, an officer or empi <br />employee of a member of Congress in connection with <br />grant, loan, or cooperative agreement, the undersignec <br />submit Standard Form-LLL, "Disclosure Form to Repoi <br />accordance with its instructions. <br />belief, that: <br />aid, by or on behalf of <br />3 to influence an <br />in connection with the <br />al grant, the making of <br />sment, and the <br />on of any Federal <br />been paid or will be paid <br />in officer or employee of <br />yee of Congress, or an <br />his Federal contract, <br />shall complete and <br />Lobbying." in <br />3) The undersigned shall require that the language of thistding <br />rtification be included in <br />the award documents for all'subawards at all tiers (incl agreements) and <br />that all subrecipient's shall certify and disclose accordi y. <br />This certification is a material representation of fact upon wh <br />when this transaction was made or entered into. Submission <br />prerequisite for making or entering into this transaction impo <br />Any person who fails to file the required certification shall be <br />not less than $10,000 and not more than $100,000 for each <br />before October 23, 1996, and of not less than $11,000 and r <br />each such failure. <br />University of La Verne <br />Grantee or Organization <br />4Z,74i 1401 <br />Mary Aguayo <br />Name of Certifying Official Signature <br />reliance was placed <br />this certification is a <br />f by 31 U.S.C. 1352, <br />bject to a civil penalty of <br />%h failure occurring on or <br />more than $110,000 for <br />Learning <br />I-itle <br />f,N(' <br />