F.T. ZIEBARTH COMPANY - Laserfiche WebLink

Home Browse Search

CITE' OF SAI~I'I'A AI~I~~ PP.03ECT X10. OS-3195 ' • PROPOSAL AND CONTRAACT AGRFEIVIENT NONLOBBYING CERTIFICATION FOR FEDERAL AIl~ CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influence or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriate funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in comlection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying • Activities," in accordance with its instntctions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub-recipients shall certify and disclose accordingly. - Bi d 's~,~~ nature ~ F.T. ZIEBARTH COMPANY Firm 04/22/10 Date g Standard Foi~n LLL may be obtained from Caltrans and FHWA offices. • TO BE INCLUDED LIST BID PACKAGE BP f~ of 26