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8022.1 <br />Apoen4lx 12c <br />RESTRICTIONS ON LOSBTING - C~LRTIlIGTION <br />By subaitting this applieetion, the applicant certifies, to <br />the beat of his or her knowledge sad belief, theft <br />(1) >110 ledsral appropriated funds have been paid or will be <br />paid, by or oa behalf of the undersigned, to nay person for <br />influencing or attempting to influence as officer os <br />employee of any agency, a Kember of Congress, an oiticer or <br />e®ployee of Congress, or as employee of a Member of Congress <br />is connection with the arardiag of any federal contract, the <br />mkiaq of nay federal grant, the making of nay ledsral loan, <br />the entering into of nay cooperative agreement, and the <br />e:tension, continuation, renewal, amendment, or modification <br />of nay federal contrsct, groat, cooperative egreement, or <br />loan. <br />(T) It any tends other thaw Tederal appropriated made Lame <br />been psid or will be.paid to nay person toe iofleeoc3.mg or <br />attempting to influence an officer or employee of nay <br />agency, a Member of Congress, as officer or esployw of <br />Congress, or~aa employee of • Member of Coagrsss ~n <br />connection with this ledsral contract, great, cooperative <br />agreement, or loan, the uaderst ed shall complete sad <br />submit Standard !oa-ELL, 'Disclosure loss to Report <br />Lobbying,' is accordance with its instructions. ~ <br />(3) The undersigned shall require that the language of this <br />certification be included is the award documents for all <br />subavards at all tiers (including subcontracts, subgrants, <br />end contracts Hader grants, loans, sad cooperative <br />agreements) end that all subreeipients shall certify and <br />disclose accordingly. <br />This certification is • mtsrial representation of tact upon <br />which reliance vas placed xhen this transaction eras made or <br />entered into. Submission of this certification is a <br />prerequisite for aakin or entering into this Lransaction <br />imposed by section 135, title 91, D.S.C. 11ay p~rsoa who <br />fails to file the required certification shall be sub~eet to <br />a civil penalty of not less than x10,000 and not more Lban <br />x100,000 toe each such failure. <br />6/90 12c-6 <br />