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25N - AGMT - TESTING SRVS
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25N - AGMT - TESTING SRVS
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Last modified
4/28/2016 3:23:22 PM
Creation date
4/28/2016 3:11:33 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25N
Date
5/3/2016
Destruction Year
2021
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Appeudix <br />ATTACHMENT 3-2: NON-1,0BBYI G CERTIFICATION <br />CERTIFICATIONS <br />GEOTECHNICAL, SPECIAL INSPECTION, Rc MATERIAL TESTING <br />The prospective participant certifies, by siping and submitting this bid or proposal, to die best orhis or Iter kncnvledge entd <br />belief, that: <br />I No federal appropriated funds have been paid or will be paid, by or on behall'ot'the undct:signed, to any <br />person Lor influencing or attempting to influence an officer or employee of any federal agency, a Member of <br />Congress, an ollioer or employee of Congress, or an employee ol'a Member of Congress in connection with <br />the awarding of any federal contract, the making of arty federal grant, the making ol'any federal loan, the <br />entering into of any cooperative agreemcnl, and the extension, continuation. renewal, amendment, or <br />modification of any federal contract, grant, loan, or cooperative ttgrecnent. <br />2. rf any f nds other titan federal appropriated funds have been paid or evill be paid m any person IN <br />of loncing, or attempting to influence any officer or employee of any 1ederal agetwy, a Mcillbor of Congress, <br />an olliocr or employee of Congress, or an employee of a Member oPCungress in connection with this federal <br />contract, grant loan, loan or cooperative agreement, the undersigned shall complete and submit a "Disclosure <br />of Lobbying Activities". <br />'Phis certilicatiort is it material representation of filet upon which reliance was placed when this transaction was made or <br />entered into. Submission ol'this ccrtitiauion is a prerequisite for ntakirrg or entering into this u-ansoction imposed by Section <br />1352, Title 31, U. S. Coda 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 [ailura <br />The prospective participant also agrees by submitting hit; or her bid or proposal that he or she shall require that the language of <br />this certllication be included in all lower tier subcontracts, vNhich exceed $100,000 and that all such sub recipients shall cortify <br />anti disclose accordingly. <br />Signed and Printed Name: /l CC�o K ---y Al lbed <br />Iide President <br />Date L -1-1 6. <br />CCity of Santa Ana RFP 15-055 ^� <br />Page A3-2 <br />25N-32 <br />
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