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W <br />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, <br />behalf of the undersigned, to any person for influencing or attempting to <br />influence an officer or employee of any agency, a Member of Congress, an officer <br />or employee of Congress, or an employe of a Member of Congress in connection with <br />the avrarding of any Federal contract, the making of any Federal grant, the making <br />of any Federal loan, the entering into of any cooperative agreement, and the <br />extension. continuation, renewal., amendmeat, or modification of any Federal <br />contract, grant, loan, or cooperative agreement. <br />(2) if any funds other than Federal appropriated funds have been paid or will <br />be paid to any person for influencing or attempting to influence an officer or <br />employee of any agency, a Member of Congress, au officer or employee of Congress, <br />or an employee of a. Member of- Congress, in connection with this Federal contract, <br />grant, loan, or cooperative agreement, the undersigned shall complete and submit <br />Standard Form-11L, "Disclosure Form to Report Labbying," in accordance -with its <br />instructions. <br />(3) The undersigned shall require that. the Language of this certification. be - <br />included in the award. documents for all subaYaards at all. tiers -(including <br />subcontracts, .subgrants, and. contracts under grants, loans, and -cooperative <br />agreements) and that all subreeipients shall certify and disclose accordingly. <br />This certification is a material representation of fact upon which.'reliauce was <br />placedwhen-this transaction was made or•entered into. Submission of this <br />certification is a prerequisite- for making or entering into . this transaction . <br />imposed by section 1352, title 31, U.S. Code. Any person vha fails to file the. <br />required certification shall be subject to a civil penalty of . not Less than <br />$10,000 and not more than $1001000 for each such failure_ <br />mw-rl IL�� 656- <br />Grantee/Contractor Organization Program .Title <br />L <br />Signature Date <br />Name of Certifying 0 ficer <br />