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CERTIFICATION REGARDING LOBBYING
<br />The undersigned Bidder/Contractor certifies, to the best 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 undersigned, to any
<br />person for influencing or attempting to influence an officer or employee of an agency, a Member of
<br />Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection
<br />with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal
<br />loan, the entering into of any cooperative agreement, and the extension, continuation, renewal,
<br />amendment, or modification of anv Federal contract, grant, loan, or cooperative agreement.
<br />(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
<br />making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or
<br />employee of Congress, or an employee of a Member of Congress in connection with this Federal contract,
<br />grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form — LLL,
<br />"Disclosure Form to Report Lobbying," in accordance with its instructions [as amended by "Government
<br />wide Guidance for New Restrictions on Lobbying", 61 Fed. Reg. 1413 (1/19/96). Note: Language in
<br />paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of
<br />1995 (P.L. 104-65, to be codified at 2 U.S.C. 1601, et seq.)]
<br />(3) The undersigned shall require that the language of this certification be included in the awards documents
<br />for all subawards at all tiers (including subcontracts,, subgrants, and contracts under grants, loans, and
<br />cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
<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 making or
<br />entering into this transaction imposed by 31, U.S.C. 1352 (as amended by the Lobbying Disclosure Act of
<br />1995). Any 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 />[Note: Pursuant to 31 U.S.C. 1352 (1)-(2)(A), any person who makes a prohibited expenditure of fails to
<br />file or amend a required certification or disclosure form shall be subject to a civil penalty of not less than
<br />$10,000 and not more than $100,000 for each such expenditure or failure]
<br />The Bidder/Contractor, certifies or affirms the truthfulness and accuracy of each statement of its certification and
<br />disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. A 3801, et
<br />seq., apply to this certification and disclosure, if any.
<br />'I Company Name:
<br />! Authorized By:
<br />(Sign) (Print Name)
<br />Date:.'D t I Q L,
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<br />00474
<br />FAPublic Works\ENGINEERING DIVISION PROJECTS\1024-17thStreet and IR Blvd Intersection\Admim\Contract Documents\00474 -
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