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CITY OF SANTA ANA
<br />PARKING LOT IMPROVEMENTS: 117530; 117534; 117535: 118014; 107560
<br />PARK IMPROVEMENTS: 107559: 112607: 117529
<br />PROPOSAL AND CONTRACT AGREEMENT
<br />CERTIFICATION FOR FEDERAL AID CONTRACTS
<br />The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his
<br />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 influencing or attempting to influence an officer or employee
<br />of any Federal Agency, a Member of Congress, an officer or employee of Congress, or an
<br />employee of a Member of Congress in connection with the awarding of any Federal contract,
<br />the making of any Federal grant, the making of any Federal loan, the entering into of any
<br />cooperative agreement, and the extension, continuation, renewal, amendment, or modification
<br />of an Federal contract, grant, loan, or cooperative agreement.
<br />(2) If any funds other Federal appropriated funds have been paid or will be paid to any person for
<br />influencing or attempting to influence an officer or employee of any Federal agency, a
<br />Member of Congress, an officer or employee of Congress, or an employee of a Member of
<br />Congress in connection with Federal contract, grant, loan, or cooperative agreement, the
<br />undersigned shall complete and submit Standard Form-LLL*, "Disclosure of Lobbying
<br />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 entering
<br />into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
<br />certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
<br />such failure.
<br />The prospective participant also agrees by submitting his or her proposal that he or she shall require
<br />that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and
<br />that all such sub- cipients shall certify and disclose accordingly.
<br />BID n t e
<br />Ct 1?-?r?
<br />Firm
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<br />Date
<br />,*?S,tanda?d Form LLL' may bepbtairied`.`.,from'?al trans or:FHWA of£ces , ;,"'. t?.s„,... ,?, ?,?„ ,.? ;'„ ,f? y _??, _ _ _?'+, ?„ _ ?'r s? ?,,, ?,„, ,,,.? ,„ ,;
<br />BP 33 of 37
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