ORANGE, COUNTY OF - 2016 - Laserfiche WebLink

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Stateent for Loan Guarantees and I oar Insurancc The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a 1lamber of Congress in connection with this commitment providing for the United Statos to tnsufc or guarantee a loan, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. Submission of this statement is a prerequisite for making or enterin; into this transaction imposed by section. 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than 5100,000 for each such failure. 2. DEBARMENT, SUSPEINSI0-1 AND OTHER RES.PONSIBILTTY NIATTERS MECT RECIPIENT : As required by Executive Orders 12549 and 12589, Debarment and Suspension, and implemented at 44 C,F.R., Part 17 (See .Article XXXlj): A. The applicant certifies that it and its principals: (1) Are not presently debarred, suspended, proposed for clebarmeut, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency; (2) Have not withal a three-year period preceding this application been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or Local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or &struction of records, rnaktug false statements, or receiving stolen property, (3) Are not presently indicted for or otherwise criminally or civilly- charged by a governmental entity (Federal, State, or focal) with commission of any of the offensesenu certification; and merated in paragraph (A)(2) of this (4) Have not within a three-year period preceding this application had one or more pub tic transactions (Federal, State, or Local) terminated for cause or default; and B. 'Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. 3. CERTIFICATIONS REGARDNG DRUG-FREE WORKPLACE RE U1RENMENTS: This certification commits the appLicant to cornptiancc with the certification requirements under 44 CY R., Part 17 Governrnent- vvide RegWrempnts for Drug -Tree IForkplctce (Grants), See Article IX, A. The grantce certifies that it will or will continue to provide a drag -free workplace by: (a) Pcib[islung a statement notifying employees that the unlawfulixianuf'acture, distribution, dispensing, passession, or use of a controlled substance is prohibited in the grantee"s workplace and specifying the actions that will be taken against employees for violation of such prohibition; Initials rx--