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City of Santa Ana I California <br />Non - Lobbying Certification <br />CITY OF SANTA ANA <br />RFF NO.: 16 -072 <br />USER FEE STUDY <br />10N -I. Oflpl'INQ CCRTtC1CATI04 <br />The prospective participant certifies, by signing and submitting this bid or proposal, to the best <br />of his or her knowledge and belief, that: <br />(1) No federal appropriated funds have been paid or will be paid, by or on behalf of die <br />undersigned, to any person for Imlueneing or attempting to influence an oMcar or <br />employee of any Federal agency, a Member of Congress, an officer or employee or <br />Congress, or an employee of a Member of Congress in connection with the awarding of <br />any Federal contract, de mailing of any Federal grant, (lie making of any Federal torn, <br />the entering into of any cooperative agreement, and die e><7ension, continuation, renewal, <br />anendmmt, or modification of any Federal contract, grant, loalt, or cooperative <br />agreement. <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 of any federal <br />agency, a Member of Congress, an officer or employee of Congress, or an employee of a <br />Member of Congress In connection with this Federal contract, grant, loan, or cooperative <br />agreement, the undersigned shall complete and submit Standard Form -LLL„ "Disclosure <br />of Lobbying Activities," in conformance with its instructions. <br />This certification is a material representation of fact upon which reliance was placed when this <br />transaction was made or entered Into. Subntssion of this certification is a prerequisite for <br />making ar entering into this trim saction imposed by Section 1552, Title 51, U.S. Code. Any <br />person who fait; to file the required certification shall be subject to a civil penalty of not less <br />than 510,000 and not more that $100,000 for each such failure. <br />1119 prospective participant also agrees by submitting his or her bid or proposal that Ire or she <br />aliull require that the language of this certification be included in all lower tier subcontracts, <br />which eseend 5100,91)0 lint alI suet ^ci nts shall c9rtifyand disclose accordingly. <br />Signed: <br />'rifle: Vice Pfasidcnt Cnoun Man eer <br />Fimi: Will4,an financial Services <br />Date: _ Jane 13.2Qjfi, <br />Comprehensive. Innovative. Trusted. 26 <br />250 -29 <br />71 <br />I1erIIP"" .• <br />City of Santa Ana <br />User fee Study <br />