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"city of Santa Ana i California <br />Non -Lobbying Ceftification <br />CITY Or SANTA ANA <br />RFP NO.; 16-072 <br />USER FEE STUDY <br />I I F <br />The prospective participant certifies, by signing and sulondaing this bid or proposal, to the beat <br />oflus or bar knowledge and belief', that: <br />(1) No Federal appropriated Ruldn have been paid or will be paid, by or on bei dr of file <br />undersigned, to ally person for influencing or allempting to influence an officer or <br />employee Of any Federal agency, a Member of Compass, an officer or employee or <br />Congress, or an employee ora Majajber orcongroas it, connection will, fine awarding of, <br />any Federal contract, the making of any redorat grant, tile making of Any Federal loot, <br />the entering into or any cooperative atineemont, and tire extension, continuation, renewal, <br />amendment, or modification of any Federal conlraot, grant, loan, or cooperoth� <br />agreement, <br />(2) If any 6nds other then Federal appropriated flun(k have been paid or will he paid to any <br />person for influencing or attempting to Influence an officer or employee of any Federal <br />aaaocy, a Member of Congress. an of"ficor or amployce of Congress, or an employee or a <br />Member orconiftess in 'dome'lion with this Federal contract, grant, loan, or Cooperative <br />agrearlern, the undersigned shall complete and submit Standard Form -ILL, "Disclosure <br />orl,olloyms Activities," in conformance will, its instruations, <br />Tills certification is a material representation of fact upon which reliance was placed when this <br />transaction was made or entered ituo. Submission of this cenificatum is a prerequisite for <br />m"lig or entering into this tramaction, imposed by Section 1352, 'ride 31, U.S, Code, Any <br />person who Who to file die required certification shalt w subject to a civit penalty or not toss <br />than SI0,000 404 1101,1110te that $t00,000 fore1c)) Sololl failure. <br />'lite prospective participant also agrees by subluirliag itis or her bid or proposal that lie or silo <br />shall require that the language of tho, conification he included in all lawar tier subcontracts, <br />which exceed $100,00'at all stjoll wr wi ' ts shall certify and disclose accordingly. <br />Signori: <br />Title! <br />Firm: <br />Date: <br />vCornprehensivo. Innovative. TrUsted, 26 City of Santa Ana <br />User Fee Study <br />