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<br />Schedule H <br />d ral Certification Re ardin Lobb in <br />Fee 9 9 Y 9 <br />(Required of Governmental Agencies and Non-Profit Organizations) <br />The undersigned 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 person for influencing or attempting to influence an officer or employee of any agency, a Member <br />of 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 person <br />for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, <br />an officer or employee of Congress, or an employee of a Member of Congress in connection with this <br />Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit <br />Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. <br />(3) The undersigned shall require that the language of this certrtcation be included in the award <br />documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, <br />loans, and 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 transaction <br />was made or entered into.. Submission of this certification is a prerequisite for making or entering into this • <br />transaction imposed by. Section 1352, Title 31, U.S. Code. Any person who fails to file the required <br />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 />4il• ~~ ~ u ~?r' d~°~~n~itlla~IerS <br />Signature Title <br />Agency rgan~zation Date <br />(Certification signature should be same as Contract signature.) <br /> <br />Schedule H -Page 1 of 1 <br />