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8022.1 <br />Appendix 12c <br />RESTRICTIONS ON LOBBYING - CERTIFICATION <br />By subml.tting this application, the applicant certifies, to <br />the best of his or her knowledge and belief, that: <br />(1) No Federal appropriated funds have been paid or will be <br />paid, by or on behalf of the undersigned, to any person for <br />Influencing or attempting to influence an officer or <br />employee of any agency, a MemAer of Congress, an officer or <br />employee of Congress, or an employee of a Member of Congress <br />in connection with the awarding of any Federal contract, the <br />making of any Federal grant, the making of any Federal loan, <br />the entering into of any cooperative agreement, and the <br />extension, continuation, renewal, amendment, or modification <br />of any Federal contract, grant, cooperative agreement, or <br />loan. <br />(2) If any funds other than Federal appropriated funds have <br />been paid or will be paid to any person for influencing or <br />attempting to influence an officer or employee of any <br />agency, a Member of Congress, an officer or employee of <br />Congress, or'an employee of a Member of Congress in <br />connection with this Federal contract, grant, cooperative <br />agreement, or loan, the undersigned shall complete and <br />submit Standard Form -LLL, •Disclosures Form to Report <br />Lobbying,• in accordance with its instructions. t <br />(3) The undersigned shall require that the language of this <br />certification be included in the award documents for all <br />subawards at all tiers (including subcontracts, subgrants, <br />and contracts under grants, loans,i and cooperative <br />agreements) and that all subrecipients shall certify and <br />disclose accordingly. <br />This certification is a material representation of fact upon <br />which reliance was placed when this transaction was made or <br />entered into. Submission of this certification is a <br />prerequisite for making or entering into this transaction <br />imposed by section 1352, title 31, D.S.C. Any person who <br />fails to file the required certification shall be subject to <br />a civil penalty of not less than $10,000 and not more than <br />$100,000 for each such failure. <br />6/90 12c -6 <br />