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CITY OF SANTA ANA <br />PROJECT NO. 12 -6760: TRAFFIC SIGNAL MODIFICATION ON MCFADDEN AVE & LYON ST <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 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 undersigned, <br />to any person for influence or attempting to influence an officer or employee of Congress, or an <br />employee of a Member of Congress in connection with the awarding of ally Federal contract, the <br />making of any Federal grant, the making of any Federal loan, the entering into of any cooperative <br />agreement, and the extension, continuation, renewal, amendment or modification of any Federal <br />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 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 this 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 <br />transaction was made or entered into. Submission of this certification is a prerequisite for malting 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 bid or proposal that he or she shall <br />ire that the language of this certification be included in all lower tier subcontracts, which exceed <br />10 000 and that all such sub- recipients shall certify and disclose accordingly. <br />Elizabeth H. Mendoza de McRae, President /CFO <br />BIDDER'S Signature <br />PTM General Engineering Services Inc. <br />Firm <br />Date <br />• Standard romt LLL maybe obtained from Caltrans and PHWA offices. <br />TO BE INCLUDED IN BID PACKAGE <br />BP 20 of 27 <br />