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EXHIBIT F <br />?E?4TH 6 <br />c yi CERTIFICATION REGARDING LOBBYING <br />DEPARTMENT OF HEALTH AND HUMAN SERVICES <br />~ x FAMILY SUPPORT ADMINISTRATION <br />s a?" <br />?r <br />usn s PROGRAM: Community Services Block Grant/ARRA <br />?O••? <br />PERIOD: July 1, 2009 through September 30, 2010 <br />The undersigned certifies, to the best of his or her knowledge and belief, that: <br />(1) No Federal appropriated funds have been paid or will be paid by or on <br />behalf of the undersigned, to any person for influencing or attempting to <br />influence an officer or employee of any agency, a Member of Congress, an <br />officer or employee of Congress, or an employee of a Member of Congress in <br />connection with the awarding of any Federal contract, continuation, renewal, <br />amendment, or modification of any Federal contract, grant, loan, or <br />cooperative agreement. <br />(2) If any funds other than Federal appropriated funds have been paid or <br />will be paid to any person for influencing or attempting to influence an officer <br />or employee of any agency, a Member of Congress, an officer or employee of <br />Congress, or an employee of a Member of Congress in connection with this <br />Federal contract, grant, loan, or cooperative agreement, the undersigned shall <br />complete and submit Standard Form LLL, "Disclosure Form to Report <br />Lobbying," in accordance with its instructions. <br />(3) The undersigned shall require that the language of this certification be <br />included in the award document for subawards at all tiers (including <br />subcontracts, subgrants, and contracts under grants, loans, and cooperative <br />agreements) and that all subrecipients shall certify and disclose accordingly. <br />This certification is a material representation of fact upon which reliance was <br />placed when this transaction was made or entered into. Submission of this <br />certification is a prerequisite for making or entering into this transaction <br />imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the <br />required certification shall be subject to a civil penalty of not less than <br />$10,000 and not more than $100,000 for each such failure. <br />Ly?i (L I <br />Title Signature <br />Agency/Organization Date <br />F1