Laserfiche WebLink
Certification Regarding Lobbying <br /> Certification for Contracts, Grants. Loans. and Cooperative Agreements <br /> The undersigned certifies,to the best 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 agency, a Member of Congress, an officer or employee of Congress,or <br /> an employee of a Member of Congress in connection with the awarding of any Federal <br /> contract,the making of any cooperative agreement, and the extension, continuation, <br /> renewal,amendment, or modification of any Federal contact,grant, loan or cooperative <br /> agreement. <br /> (2) If any funds other than Federal appropriated funds have been paid or will be paid to <br /> any person for influencing or attempting to influence an officer or employee of any <br /> agency, a Member of Congress, an officer or employee of Congress, or an employee of a <br /> Member of Congress in connection with this Federal contract, grant, loan, or cooperative <br /> agreement,the undersigned shall complete and submit Standard Form-LLL, "Disclosure <br /> of Lobbying Activities," in accordance with its instructions. <br /> (3) The undersigned shall require that the language of this certification be included in the <br /> award documents for all subawards at all tiers (including subcontract, subgrants, and <br /> contracts under grants, loans, and cooperative agreements) and that all subrecipients shall <br /> certify and disclose accordingly. <br /> This certification is a material representation of fact upon which reliance was placed <br /> when this transaction was made or entered into. Submission of this certification is a <br /> prerequisite for making or entering into this transaction imposed by Section 1352,Title <br /> 31, U. S.Code. Any person who fails to file the required certification shall be subject to <br /> a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. <br /> Interval House Domestic Violence Shelter Services <br /> Grantee/Contactor Orga ' tion Program Title <br /> ti <br /> Carol Williams ILGI yC.�� 0112-1 --1-( <br /> Name of Certifying Officer Signature Date <br /> EXHIBIT D <br /> Page 1 of 2 <br />