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CITY OF SANTA ANA RE -BID <br />PROPOSAL <br />PROJECT NO. 16-7523 <br />WASHINGTON SQUARE RESIDENTIAL STREET REPAIR <br />FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION <br />Name of Finn: EBS GENERAL ENGINEERING INC Date: 12/23/15 <br />Address: 1320E SIXTH ST, STE 100 CORONA <br />State: CA Zip Code: 92879 Telephone: 951-279-6869 <br />Acting on behalf of the above-named firth as its Authorized Official, I make the following <br />Certification to the Department of Housing and Urban Development (HUD) and the Community <br />Development Commission, County of Los Angeles: <br />1. No Federal appropriated funds have been paid, by or on behalf of the above-named firm to <br />any person for influencing or attempting to influence an officer or employee of any agency, a <br />Member of Congress, an officer or employee of Congress, or an employee of a Member <br />of Congress in connection with the awarding of any Federal contract, the making of any <br />Federal grant, loan, or cooperative agreement, and any extension, continuation, renewal, <br />amendment, or modification thereof; and <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 or any agency, 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 />above-named firm shall complete and submit Standard Form—LLL, "Disclosure Form to <br />Report Lobbying" in accordance with its instructions; and <br />3. The above-named firm shall require that the language of this certification be included in the <br />award documents for all sub -awards at all tiers (including subcontracts, sub -grants, and <br />contracts under grants, loans, and cooperative agreements) and that all sub -recipients 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 <br />making or entering into the transaction imposed by Section 1352 Title 31 U.S. Code. Any <br />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 />Authorized Official: <br />JOSEPH A NANCI <br />Name <br />Sig, re <br />PRESIDENT <br />Title <br />12/23/15 <br />Date <br />P-24 of P-25 <br />