Laserfiche WebLink
Appendix <br />ATTACHMENT 3m2: NON-LOBBYING CERTIFICATION <br />Cr1,RT111FICr4')p 0NS <br />CONSTRIICTABILITY REVIEW <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 malting of any federal grant, the maldng 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 agrccmcrit. <br />1 If any funds 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 submit a "Disclosure <br />of Lobbying Activities ". <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 malting or entering into this transaction imposed by Scetion <br />1352, Two 31, US, Code. Any person who fails to file the required oertiflcation 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 language of <br />this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify <br />and disclose accordingly, <br />h.J <br />Signed and Printed Name: <br />Title i.I c t <br />bate j <br />L <br />City of Santa Ana RI=1n 16-008 <br />Page A3 -2 <br />25C -20 <br />