25L - AGMT - ON-CALL RIGHT OF WAY SRVS

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ATTACHMENT 3-2: WON-LORBYING CERTIFICATION CERTIFICATIONS CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR ON -CALL RIGHT OF WAX SPECIALTY SERVICE REP NO.t 15 -044 The prospective participant certifies, by signingand submitting this bid or proposal, to the best of his or her knowledge and belief, that: No federal appropriated funds have been paid or will be paid, by or on behalf ofthe undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant; the making of any federal low), the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment; or modification of any federal contract, grant, loan, or cooperative agreement. 2, If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence any officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant loan, loan or cooperative agreement, the undersigned shat l complete and submit a °'Disclosure of Lobbying Activities % This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, V, S. Code. Any person who faits to file the required certification shall be subject to a civil penalty of not less than $10 000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the tanguage of this certification be me] oiled in all lower tier subcontracts, which exceed $100,000and that all such sub recipients shall certify and disclose accordingly. Firm I—i TCL M 1 126 m Signed and Printed Name: 3L !'Td I*✓rA Date j Ulf }r 1 City of Santa Ana RFP 1$-044 Page 29 25L -114