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0 CITY OF SANTA ANA <br />ATTACHMENT E <br />NON -LOBBYING CERTIFICATION <br />The prospective participant corlifies, by signing and submitting this bid or proposal, to the best of his or <br />her knowledge and belief, that: <br />(1) No Federal appropriated funds have been paid orwilt be paid, by or on behalf of the undersigned, <br />to any person for Influencing or attempting to Influence an officer or employee of any Federal <br />agency, a Member of Congress, an officer or employoo of Congress, or an employee of a Member <br />of Congress In connection with the awarding of any Federal contract, the making of any Federal <br />grant, the malting of any Federal loan, the entering Into of any cooperative agreement, and the <br />extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, <br />or cooperative agreement. <br />(2) If any funds other than Federal approprlatod funds have boon paid or will be paid to any person <br />for Influencing or attempting to Influence an officer or employee of any Federal agency, a Member <br />of Congress, an officer or employee of Congress, or an employee of a Member of Congress In <br />connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned <br />shall complete and submit Standard Form-LI_L, "Disclosure of Lobbying Activities," in <br />conformance with its Instructions. <br />This certification Is a material representation of fact upon which reliance was placed when this transaction <br />was made or entered into. Submission of this certification Is a prerequisite for making or entering Into <br />this transaction imposed by Section 1352, Title 31, U,S. Code. Any person who fails to file the required <br />cerlificatlon shall be subject to a civil penally of not less than $10.000 and not more than $100,000 for <br />each such failure. <br />The prospective participant also agrees by submitting his or her bid or proposal that he or she shall <br />require that the language of this cortlflcgtio be included In all lower tier subcontracts, which exceed <br />$100,000 and t t-al uch subreclple sh Il certify and disclose accordingly. <br />Slgr <br />Title,. 1. rIsi.dent <br />Firm: J&G Industries Inc <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL RE CONSIDERED NONRESPONSIVE. <br />City of Sonia Ana nFP Na. 26.027 Pape 37 of 41 <br />