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grant, the entering into of any cooperative agreement, and the extension, continuation,
<br />renewal, amendment, or modification of any Federal grant or cooperative agreement;
<br />(b) If any funds other than Federal appropriated funds have been paid or will be paid to any
<br />person for influencing or attempting to influence an officer or employee of any agency, a
<br />Member of Congress, an officer or employee of Congress, or an employee of a Member of
<br />Congress in connection with this Federal grant or cooperative agreement, the undersigned
<br />shall complete and submit Standazd Form - LLL, "Disclosure of Lobbying Activities," in
<br />accordance with its instructions found at www.whitehouse.gov/omb/grants.
<br />(c) The undersigned shall require that the language of this certification be included in the
<br />award documents for all subawazds at all tiers (including subgrants, contracts under grants
<br />and cooperative agreements, and subcontracts) and that all sub-recipients shall certify and
<br />disclose accordingly.
<br />2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT
<br />RECIPIENT):
<br />As required by Executive Order 12549, Debarment and Suspension, and implemented at 28
<br />CFR Part 67, for prospective participants in primary covered transactions, as defined at 28
<br />CFR Part 67, Section 67.510
<br />A. The applicant certifies that it and its principals:
<br />(1) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
<br />sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily
<br />excluded from covered transactions by any Federal department or agency;
<br />(2) Have notwithin athree-yeaz period preceding this application been convicted of or had
<br />a civil judgment rendered against them for commission of fraud or a criminal offense
<br />in connection with obtaining, attempting to obtain, or performing a public (Federal,
<br />State, or local) transaction or contract under a public transaction; violation of Federal
<br />or State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
<br />falsification or destruction of records, making false statements, or receiving stolen
<br />property;
<br />(3) Are not presently indicted for or otherwise criminally or civilly charged by a
<br />governmental entity (Federal, State, or local) with commission of any of the offenses
<br />enumerated in pazagraph (A)(2) of this certification; and
<br />(4) Have not within athree-year period preceding this application had one or more public
<br />transactions (Federal, State, or local) terminated for cause or default; and
<br />B. Where the applicant is unable to certify to any of the statements in this certification, he or
<br />she shall attach an explanation to this application.
<br />3. CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION, AND
<br />OTHER RESPONSIBILITY MATTERS; AND DRUG FREE WORKPLACE
<br />REQUIREMENT: This certification, which is a required component of the on-line
<br />application, commits the applicant to compliance with the certification requirements under 28
<br />CFR part 67, Government-wide Debarment and Suspension (Non nrocurement),~ 28 CFR part
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