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CITY OF SANTA ANA <br />PROPOSAL NO. 10-7504 <br />PROPOSAL AND CONTRACT AGREEMENT <br />NONLOBBYING <br />CERTIFICATION FOR FEDERAL AID CONTRACTS <br />The prospective participant certifies, by signing and submitting this bid or proposal, to the best <br />of his or her knowledge and belief, that: <br />(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the <br />undersigned, to any person for influence or attempting to influence an officer or employee of <br />Congress, or an employee of a Member of Congress in connection with the awarding of any <br />Federal contract, the making of any Federal grant, the making of any Federal loan, the <br />entering into of any cooperative agreement, and the extension, continuation, renewal, <br />amendment or modification of any Federal contract, grant, loan, or cooperative agreement. <br />(2) If any funds other than Federal appropriate funds have been paid or will be paid to any <br />person for influencing or attempting to influence an officer or employee of any Federal <br />agency, a Member of Congress, an officer or employee of Congress, or an employee of a <br />Member of Congress in connection with this Federal contract, grant, loan, or cooperative <br />agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of <br />Lobbying Activities," in accordance with its instructions. <br />This certification is a material representation of fact upon which reliance was placed when this <br />transaction was made or entered into. Submission of this certification is a prerequisite for making or <br />entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to <br />file the required certification shall be subject to a civil penalty of not less than $10,000 and not more <br />than $100,000 for each such failure. <br />The prospective participant also agrees by submitting his or her bid or proposal that he or she <br />shall require that the language of this certification be included in all lower tier subcontracts, which <br />exceed $100,000 and that all such sub-recipients shall certify and disclose accordingly. <br />- - ~--~ <br />_. <br />.. <br />~_ <br />~~ <br />BI s Signature ~DcR-1~1 C-~~1,C,{-~~E~v~ <br />~1..~~~~z ~-AV 1 I~G C~'M~-~t~~la I N~ . <br />Firm <br />C-~' 2J~-P . ~`lV <br />Date <br />• ~ Standard Form LLL may be obtained from Caltrans and FHWA offices. <br />TO BE INCLUDED IN BID PACKAGE <br />BP 24 of 31 <br />