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CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15 -6834 TRAFFIC SIGNAL MODIFICATIONS: 171tt STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET", WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: FISIPL 5063(156) NON - LOBBYING CERTIFICATION FOR FEDERAL AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (l) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influence or attempting to influence all officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the malting of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriate fwtds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Mernber of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to the the required certification shall be subject to a civil penalty of not less than $'10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by sub,4tting his or her bid or proposal that he or she shall require that the language of d is certification b it clucked in all lower tier subcontracts, which exceed $100,000 and that all such su�) -rec itwits shaIj,,vetjt�f" and disclose accordingly. Signed Title President Firm California Professional Engineering Inc. Date 05/04/2016 Standard Forin LLL may be obtained from Caltrans and FHWA offices. P -24 of P -40 20D -39