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<br />CONTRACT NO: <br /> <br />EXHIBIT H <br />PAGE 1 OF3 <br /> <br />6744 FEDERAL REGISTER VOLUME 55. No. 38/ MONDAY. FEBRUARY 26.1990/ RULES AND REGULATIONS <br /> <br />INSTRUCTIONS FOR COMPLETION OF SF-LLL DISCLOSURE OF LOBBYING ACTIVITIES <br /> <br />This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient at the <br />initiation or receipt of a covered Federai action, or a material change to a previous filing, pursuant to title 31 U,S,C. <br />section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity <br />for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or <br />empioyee of Congress. or an employee of a Member of Congress in connection with a covered Federal action. Use <br />the SF-LLL-A Continuation sheet for additional information if the space on the form is inadequate. Complete all items <br />that appiy for both the initial filing and material change report. Refer to the implementing guidance published by the <br />Office of Management and Budget for additional information. ' <br /> <br />1. Identify the type of covered Federal action for which lobbying is and has been secured to influence the outcome of <br />a covered action. <br />2. Identify the status olthe covered Federal action. <br />3. Identify the appropriate classification of this report. If this is a foiiow up report caused by a material change to the <br />information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last <br />previously submitted report by this reporting entity for this covered Federal action. <br />4. Enter the fuii name, address, city, state and zip code of the reporting entity. Include congressionai district, if known. <br />Check the appropriate classification of the reporting entity that designates if it is, or expects to be a prime or <br />subaward recipient. identify the tier of the subawardee, e. g. the first subawardee of the prime is the 1st tier. <br />Subawards include but are not limited to subcontracts. subgrants and contract awards under grants, <br />5. If the organization filing the report, in item 4 checks "Subawardee", then enter the fuii name, address, city, state, <br />and zip cOde of the prime Federai recipient. include congressional district, if known. <br />6. Enter the name of the Federal agency making the award or loali commitment. Include at least one organizational <br />level below agency name, if known. For example, Department of Transportation, United States Coast Guard. <br />7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the fuii <br />Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and ioan <br />commitments. ' <br />8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e. g, <br />Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number the contract, grant. <br />or loan award number; the application proposal control number assigned by the Federal agency). Include prefixes, <br />e.g., "RFP-DE-90-09." <br />9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the <br />Federal amount of the award/loan commitment for the primary entity identified in item 4 or 5. <br />10. (a) Enter the fuii name, address, city, state and zip code of the lobbying entity engaged by the reporting entity <br />identified in item 4 to influence the covered Federal action. <br />(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a), <br />Enter Last Name, First Name, and Middle Initial (MI). <br />11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the <br />lobbying entity (item 10). Indicate whether the payment has been made (actual) or wiii be made (planned). Check aii <br />boxes that apply. If this is a material change report enter he cumulative amount of payment made or planned to be <br />made. <br />12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, <br />specify the nature and value of the in-kind payment. <br />13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. <br />14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to <br />perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in <br />actual contact with Federal officials. Identify the Federal official(s) or employee(s) contacted and the officer(s), <br />employee(s), or Member(s) of Congress that were contacted. <br />15. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached. <br />16. The certifying official shaii sign and date the form, print his/her name, title, and telephone number. <br /> <br />Public reporting burden for this collection of information is estimated to average 30 minutes per response, including <br />time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and <br />completing and reviewing the coiiection of information. Send comments regarding the burden estimate or any other <br />aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management <br />and Budget. Paperwork Reduction Project (0348-0046) Washington D,C., 20503. <br />