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i <br />CERTIFICATIOU908RDING LOBBYING <br />CERTIFICATION FOR CONTRACTS GRANTS LOANS <br />and COOPERATIVE AGREEMENTS <br />The undersigned certifies, to the best of his 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 <br />undersigned, to any person for influencing or attempting to influence an officer or employee <br />of any organization, a Member of Congress in connection with the awarding of any Federal <br />contract, the making of any Federal grant, the making of any Federal loan, the entering into of <br />any cooperative agreement, and the extension, continuation, renewal, amendment, or <br />modification of any Federal contract, grant, loan, or cooperative agreement. <br />2) If any funds other than Federal appropriated funds have been paid or will be paid to any <br />person for influencing or attempting to influence an officer or employee of any organization, a <br />Member of Congress, an officer or employee of Congress, or an employee of a member of <br />Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the <br />undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report <br />Lobbying." in accordance with its instructions. <br />3) The undersigned shall require that the language of this certification be included in the award <br />documents for all subawards at all tiers (including agreements) and that all subrecipients shall <br />certify and disclose accordingly. <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 making or <br />entering into this transaction imposed by 31 U.S.C. 1352. <br />Any person who fails to file the required certification shall be subject to a civil penalty of not less than <br />$10,000 and not more than $100,000 for each such failure occurring on or before October 23, 1996, <br />and of not less than $11,000 and not more than $110,000 for each such failure. <br />C ✓ \u) C — ^1L- -p <br />Grantee /Contractor Organization <br />Si nat a Date <br />c�.i0, (�'e- . �D <br />Name of Certifying Official Signature <br />32 <br />