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of an agency, a Member of Congress, an officer or employee of Congress, or an employee of <br />a Member of Congress in connection with the awarding of any federal contract, the making of <br />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 <br />federal contract, grant, loan, or cooperative agreement. <br />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 agency, a <br />Member of Congress, an officer or employee of Congress, or an employee of a Member of <br />Congress in connection with this federal contract, grant, loan, or cooperative agreement, the <br />undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report <br />Lobbying," in accordance with its instructions. <br />The undersigned shall require that the language of this certification be included in the award <br />documents for all subawards at all tiers (including subcontracts, subgrants, and contracts <br />under grants, loans, and cooperative agreements) and that all subrecipients shall certify and <br />disclose accordingly. <br />This certification is a material representation of fact upon which reliance was placed when <br />this transaction was made or entered into. Submission of this certification is a prerequisite <br />for making or entering into this transaction imposed by section 1352, Title 31, U.S.C. 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 />10.3.2 RECOMMENDED SIGNATURE LINE: <br />At the end of the certification language, FEMA recommends including the following signature <br />line. <br />"The Contractor, , certifies or affirms the truthfulness and accuracy <br />of each statement of its certification and disclosure, if any. In addition, the Contractor <br />understands and agrees that the provisions of 31 U.S.C. Chap. 38, Administrative Remedies <br />for False Claims and Statements, apply to this certification and disclosure, if any. <br />Signature of Contractor's Authorized Official <br />Name and Title of Contractor's Authorized Official <br />Date" <br />30 <br />