Laserfiche WebLink
<br />Exhibit D <br /> <br />CERTIFICATION REGARDING LOBBYING <br /> <br />CERTIFICATION FOR CONTRACTS, GRANTS LOANS <br />and COOPERATIVE AGREEMENTS <br /> <br />The undersigned certifies. to the best of his or her knowledge and belief, that: <br /> <br />'II No Federal appropriated funds have been paid or will be paid, by or on behalf <br />of the undersigned, to anv person for influencing or attempting to influence <br />an officer or employee of an agency, a Member of Congress, an officer or <br />employee of Congress, or an employee of a Member of Congress in <br />connection with the awarding of any Federal contracts, the making of any <br />Federa', grant. the making of any Federal loan, the entering into of any <br />cooperative agreement, and the extension, continuation, renewal, <br />amendment or modification of any Federal contract, grant, loan or <br />cooperative agreement. <br /> <br />2) If any funds other than Federal appropriated funds have been paid or will be <br />paid to any person for influencing or attempting to influence an officer or <br />emploVee of any agency, a lv1ember of Congress, an officer or employee of <br />Congress, or an emploVee of a lv1ember of Congress in connection with this <br />Federal contract, grant, loan or cooperative agreement, the undersigned shall <br />complete and submit Standard Form - LLL, "Disclosure Form to Report <br />Lobbying," in accordance with its instructions. <br /> <br />31 The undersigned shall require that the language of this certification be <br />included in the award documents for all subawards at all tiers (including <br />agreements I and that all subrecipients shall certify and disclose accordingly. <br /> <br />This certification is a material representation of fact upon which reliance was <br />placed when this transaction was made or entered into. Submission of this <br />certification is a prerequisite for making or entering into this transaction imposed by <br />31 U.S.C. 1352. Any person who fails to file the required certification shall be <br />subject to a civil penalty of not less than $10,000 and not more that $100,000 for <br />each such failure. <br /> <br />Grantee/Contractor Organization ~ program. Title ~!. <br /> <br />~ ~_lC (3U' - c) C~~~~~,~'c- <br />Ot--- ~ ~ 1(y t<; ~ "'" ~ .' - <br /> <br />Name of Certifying Off ial Si n ure ~ ~ d- u-~ <br /> <br />~_ o-~~ <br />