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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 , <br /> to any <br /> person for influencing or attempting to influence an officer or employee of an agency, a <br /> 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 any 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 <br /> 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 (inclining subcontracts , subgrantsF 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 <br />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 <br /> and <br /> disclosure, if any. In addition , the Contractor understands and agrees that the provisions rof 31 U . S . C . A <br /> 3801 , et <br /> seq. , apply to this certification and disclosure, if any. <br /> w <br /> Company Name: • <br /> Authorized By : ii b 4S <br /> (Sign) (Print Name) <br /> Title : jie4GL': Date : ( z <br /> WWks <br /> 00474 <br /> bllc Works\ENGINEERING DIVISION PROJECTS\1102-Old Dixie Hwy Swk 8th St to SR 60-LAP\Admimlbid documents\LAP <br /> ;� ts�\00474 - CERTIFICATION REGARDING LOBBYING.doc <br />