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2015-025C
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Last modified
3/29/2017 3:25:42 PM
Creation date
4/26/2016 1:11:32 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
02/17/2015
Control Number
2015-025C
Agenda Item Number
8.F.
Entity Name
Timothy Rose Construction
Subject
Contract/Specifications Old Dixie Sidewalk Improvements
Part 3
Area
38th Lane to 45th St.
Project Number
0845B
Bid Number
2014032
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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 person for <br />influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or <br />employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal <br />contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative <br />agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, <br />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 making lobbying <br />contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or <br />an employee of a 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 Form to Report <br />Lobbying," in accordance with its instructions [as amended by "Government wide Guidance for New Restrictions on <br />Lobbying", 61 Fed. Reg. 1413 (1/19/96) Note. Language in paragraph (2) herein has been modified in <br />accordance with Section 10 of the Lobbying Disclosure Act of 1995 (P L. 104-65, to be codified at 2 U.S C. 1601, et <br />seq )] <br />(3) <br />The undersigned shall require that the language of this certification be included in the awards documents for all <br />subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative <br />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 transaction was <br />made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction <br />imposed by 31, U S.C. 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the <br />required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for <br />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 file or <br />amend a required certification or disclosure form shall be subject to a civil penalty of not less than $10,000 and not <br />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 disclosure, if <br />any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.0 A 3801, et seq., apply to this <br />certification and disclosure, if any <br />Company Name: <br />Authorized By: <br />(Sign) (Print Name) <br />Title: Date: <br />P-17 <br />8262014 3:3829 PM <br />
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