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Certification Regarding Lobbying
<br /> Certification for Contracts , Grants , Loans , and Cooperative
<br /> Agreements
<br /> pr 1P
<br /> The undersigned certifies , to the best of his or her knowledge and
<br /> belief , that :
<br /> ( 1 ) No Federal appropriated funds have been paid or will be paid ,
<br /> by or on behalf of the undersigned , to any person for influencing
<br /> I r attempting to influence an officer or employee of any agency ,
<br /> a Member of Congress , an officer or employee . of Congress , or an
<br /> employee of a Member of Congress in connection with the awarding
<br /> of `: ariy Federal contract , the making of ` -. any Federal grant , ` the
<br /> ;. K , making of ; any Federal loan , the entering into of any cooperative
<br /> ag`reement , . ` and the extension , continuation renewal ' -, amendment ,' Or
<br /> modification of any Federal contract , grant , loan ,, ,,.. - Or cooperative
<br /> _ .
<br /> • agreement . - c :
<br /> ( 'Z , ) If any Ifunds other than Federal appropriated funds have been
<br /> 14 paid or will be paid to any person for influencing =; or . attempting
<br /> to influence , an officer or employee of any agency;, a _ Member of -
<br /> Congre ss :officer or employee of Congress , or an > employee of a
<br /> ; Member, , of Congress in connection with this Federal contract ; grant ,
<br /> � 1oan , or cooperative agreement , the _ undersi. gned shall complete and
<br /> ' ` x'� ' submit : Standard Form- LLL , " Disclosure Form to Rep- ort : Lobb "
<br /> Ying , in
<br /> IV
<br /> accord'3nce _, wlth' is instructions . ,
<br /> n'
<br /> ( 3 ) The undersigned shall require that the language of this
<br /> certificat on , be included in the award documents for` all : subawards
<br /> =tiers " " ' '( including subcontracts , subgrants , Wand contracts
<br /> tender : grants , " ; , 'loans , and cooperative agreements ) .. . and : that - : all
<br /> subrecipients shall certify and disclose accordingly .
<br /> This certification is a material representation of fact upon which
<br /> ..reliance was placed when this transaction was made or entered unto .
<br /> Submission of this certification is a prerequisite for making or
<br /> entering i•nto. this transaction imposed by section 1352 , title 31- ,
<br /> U . S . Code . Any person who fails tofile the required certification
<br /> shall be subject to a civil penalty of not less than $ 10 , 000 and not
<br /> more than $ 100 , 000 for each such failure .
<br /> Kennp.tb R . Macht , Chairman
<br /> Typed Na itle of A orized Representative
<br /> 09 - 16 - 2003
<br /> Sig t re of Kut ized epresentative Date
<br /> Page 20
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