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The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and
<br />belief, that:
<br />1. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
<br />person for 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 connection with
<br />the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the
<br />entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
<br />modification of any federal contract, grant, loan, or cooperative agreement.
<br />1 if any finds other than federal appropriated funds have been paid or will be paid to any person for
<br />influencing or attempting to influence any officer or employee of any federal agency, a Member of Congress,
<br />an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal
<br />contract, grant loan, loan or cooperative agreement, the undersigned shall complete and sub'm'it a "Disclosure
<br />of Lobbying Activities".
<br />i
<br />This certification is a material representation of fact upon which reliance was placed when this transaction was made or
<br />entered into. Submission of this certification is a prerequisite for making or entering into this transaction unposed by Section
<br />1352, Title 31, U S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less
<br />than $10,000 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 she shall require that the langaage of
<br />this certification be included in all lower tier subcontracts, wl-rich exceed $100,000 and that all such sub recipients shall certify
<br />and disclose accordingly.
<br />Signed and Printed Name:
<br />Title.._ Division,Presiderpt
<br />Date
<br />A'1TACI VIENT 3 2: NON- L013I3Y1NC CER "�IF$GATIOIY
<br />CERTIFICATIONS
<br />CITY OF SANTA ANA
<br />REQUEST FOR PROPOSALS
<br />FOR
<br />ON -CALL ENGINEERING SERVICES — PART B
<br />REP NO.: 14 -037B
<br />The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and
<br />belief, that:
<br />1. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
<br />person for 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 connection with
<br />the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the
<br />entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
<br />modification of any federal contract, grant, loan, or cooperative agreement.
<br />1 if any finds other than federal appropriated funds have been paid or will be paid to any person for
<br />influencing or attempting to influence any officer or employee of any federal agency, a Member of Congress,
<br />an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal
<br />contract, grant loan, loan or cooperative agreement, the undersigned shall complete and sub'm'it a "Disclosure
<br />of Lobbying Activities".
<br />i
<br />This certification is a material representation of fact upon which reliance was placed when this transaction was made or
<br />entered into. Submission of this certification is a prerequisite for making or entering into this transaction unposed by Section
<br />1352, Title 31, U S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less
<br />than $10,000 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 she shall require that the langaage of
<br />this certification be included in all lower tier subcontracts, wl-rich exceed $100,000 and that all such sub recipients shall certify
<br />and disclose accordingly.
<br />Signed and Printed Name:
<br />Title.._ Division,Presiderpt
<br />Date
<br />
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