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CITY OF SANTA ANA <br />PROJECT TITLE & NO. # <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 <br />best of his or her knowledge and belief, that: <br />(1) No Federal appropriated funds have been paid or will be pc the <br />undersigned, to any person for influence or attempting to influence an officer or <br />employee of Congress, or an employee of a Member of Congress in connection with the <br />awarding of any Federal contract, the making of any Federal grant, the making of any <br />Federal loan, the entering into of any cooperative agreement, and the extension, <br />continuation, renewal, amendment or modification of any Federal contract, grant, loan, <br />or cooperative agreement. <br />(2) If any funds other than Federal appropriate funds have been paid or will be paid to any <br />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 <br />Member of Congress in connection with this Federal contract, grant, loan, or cooperative <br />agreement, the undersigned shall complete and submit Standard Fonn -LLL, "Disclosure <br />of Lobbying Activities," in accordance with its instructions. <br />This certification is a material representation of fact upon which reliance was placed when <br />this transaction was made or entered into. Submission of this certification is a prerequisite for <br />malting or entering into this transaction unposed by Section 1352, Title 31, U.S. Code. Any person <br />who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 <br />and not more than $100,000 for each such failure. <br />The prospective participant also agrees by submitting his or her bid or proposal that he or <br />she shall require that the language of this certification be included in all lower tier subcontracts, <br />which exceed $100,000 and that all such sub- recipients shall certify and disclose accordingly. <br />C-T, ✓ 11 , K 33rHOWP4,MESIDENT <br />BIDDER'S Signature <br />y <br />r�L? s�FES,i�2.^ <br />0103 L NMsR, 1 CO'i,2 °,% ?tiN,i'f <br />Firm <br />ate <br />. Slundard Form LLL may be obtained £rotn Caltrans and Fn WA offices. <br />BP 19 of 26 <br />23BB -29 <br />