Laserfiche WebLink
CITY OF SANTA ANA <br />PROJECT NO. 13 -7513: EL SALVADOR PARK WALKWAY RECONSTRUCTION <br />PROJECT NO. 13 -7514: WINDSOR PARK WALKWAY RECONSTRUCTION <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 or <br />her knowledge and belief; that: <br />(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, <br />to any 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 Member <br />of Congress in connection with the awarding of any Federal contract, the making of any Federal <br />grant, the making of any Federal loan, the entering into of any cooperative agreement, and the <br />extension, continuation, renewal, amendment, or modification of an Federal contract, grant, loan, <br />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 Member of <br />Congress, an officer or employee of Congress, or an employee of a Member of Congress in <br />connection with Federal contract, grant, loan, or cooperative agreement, the undersigned shall <br />complete and submit Standard Form -LLL *, "Disclosure of Lobbying Activities" in accordance <br />with its instructions. <br />This certification is a material representation of fact upon which reliance was placed when this transaction <br />was made or entered into. Submission of this certification is a prerequisite for making or entering into this <br />transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification <br />shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. <br />The prospective participant also agrees by submitting his or her proposal that he or she shall require that <br />the Lang ag of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all <br />such sub - a 'pien s all certify and disclose accordingly. <br />BIDDER Signature <br />Firm <br />J A z�- -Z <br />Date <br />*Standard Form LLL may be obtained from Caltrans or FHWA offices. <br />TO BE INCLUDED IN BID PACKAGE <br />BP 26 of 30 <br />