Orange County NC Website
Browse       Search
27 <br />State Fiscal Year 2013 Public Transportation Programs <br />Federal and State Assistance Certifications and Assurances <br />(Required of all Applicants) <br />CERTIFICATION AND RESTRICTIONS ON LOBBYING <br />I, <br />Bernadette Pelissier <br />on behalf of <br />Name of Authorized Official <br />Orange County <br />Legal Name of Applicant <br />Hereby certifies that: <br />No FederaUState appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any <br />person for influencing or attempting to influence an officer or employee of any FederaUState agency, a Member <br />of Congress or State Legislature, an employee of a member of Congress or State Legislature, or an officer or <br />employee of Congress or State Legislature in connection with the awarding of any FederaUState contract, the <br />making of any FederaUState grant, the making of any FederaUState loan, the entering into of any cooperative <br />agreement, and the extension, continuation, renewal, amendment, or modification of any FederaUState contract, <br />grant, loan, or cooperative agreement. <br />If any funds other than FederaUState appropriated funds have been paid or will be paid to any person <br />influencing or attempting to influence an officer or employee of any FederaUState agency, a Member of <br />Congress or State Legislature, an employee of a member of Congress or State Legislature, or an officer or <br />employee of Congress or State Legislature in connection with the FederaUState contract, grant, loan, or <br />cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "Disclosure Form to <br />Report Lobbying," in accordance with its instructions. <br />The undersigned shall require that the language of this certification be included in the award documents for all <br />sub-awards at all tiers (including sub-contracts, sub-grants and contracts under grants, loans, and cooperative <br />agreements) and that all sub-recipients shall certify and disclose accordingly. <br />This certiflcation is a material representation of fact upon which reliance was placed N~hen this transaction Naas <br />made or entered into. Submission of this certifr.cation is a prerequisite for making or entering into this <br />transaction imposed by 31 U.S.C. ,~ 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person <br />who fails to file the required certification 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 />The undersigned certifies or arms the truthfulness and accuracy of the contents of the statements submitted on <br />or- ~vitlz this certification and understands that the provisions of 31 U.S.C. Section 3801, et seq., are applicable <br />thereto. <br />Signature of Authorized Official <br />Seal Subscribed and sworn to me (date) <br />Notary Public <br />Printed Name and Address <br />My commission expires (date) <br />24 <br />r~~---....---~ .................................................................................... <br />Affix Notary Seal Here <br />