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CITY OF SANTA ANA <br />RFP NO.: 17-101 <br />ENTERPRISE ASSET MANAGEMENT SOFTWARE SELECTION AND <br />IMPLEMENTATION SERVICES <br />NON -LOBBYING CERTIFICATION <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 the <br />undersigned, to any person for influencing or attempting to influence an officer or <br />employee of any Federal agency, a Member of Congress, an officer or employee of <br />Congress, or an employee of a Member of Congress in connection with the awarding of <br />any Federal contract, the malting of any Federal grant, the malting of any Federal loan, <br />the entering into of any cooperative agreement, and the extension, continuation, renewal, <br />amendment, or modification of any Federal contract, grant, loan, 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. Submission of this certification is a prerequisite for <br />making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any <br />person who fails to file the required certification 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 <br />shall require that the language of this certification be included in all lower tier subcontracts, <br />which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. <br />Signed: <br />Title: <br />Firm: <br />Date: <br />25K-36 Page I of <br />