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CITY OF SANTA ANA RFF NO,: 22-096 ON CALL EMERGENCY ASPHALT & PCC NON -LOBBYING CLRTIC CATION Tho prospective participant certifies, by signing and submitting this bid or proposal, to the hest of his or her knowledge and belief, that; (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned; to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress 1n connection with the awarding of any Federal contract, the making of any Federal grant, the malting of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract,. grant, loan, or cooperative agreement, (2) if any fiends other than Federal appropriated finds have been paid or will be paid to any person for influencing or attempting to inf1L1enr:e an alPcer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract; grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL "Disclosure of Lobbying Activities," in conformance with its instructions, This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into, Submission ofthiseertifioationisaprerequisite for mnking or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to fife the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure; The prospective participant also agrees by submitting his or her bid or proposal that fie or she shall require that the language of this certifoation be included in all lower tier subcontracts, which exceed $100,000 ail 'hat a I such subrecipients shall certify and disclose accordingly. Signed: 'u e r Title: Vice President Firm! Vido Samarzich, Inc. Date; 02/06/2023 Page 8 of to