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Contract Number 00027858 / Page 29 of 33
<br /> V. Certification Regarding Lobbying
<br /> The Provider 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, to any person for
<br /> influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or
<br /> employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal
<br /> contract, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative
<br /> agreement.
<br /> 2 If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
<br /> attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
<br /> Congress, or an employee of a Member of Congress in connection with this Federally funded contract, grant, loan, or
<br /> cooperative agreement, the undersigned shall complete and submit Standard Form SF -LLL, "Disclosure of Lobbying
<br /> Activities," in accordance with its instructions.
<br /> 3: The undersigned shall require that the language of this certification be included in the award document for subawards
<br /> at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) who
<br /> receive federal funds of $100,000.00 or more and that all subrecipients shall certify and. disclose accordingly
<br /> 4. This certification is a material representation of fact upon which reliance was placed when this transaction was made
<br /> or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
<br /> Section 1352, Title 31, U S. Code. Any person who fails to file the required certification shall be subject to a civil
<br /> penalty of not less than $10,000,00 and not more than $100,000 00 for each such failure
<br /> Vi. Disclosure Of Lobbying Activities
<br /> Instructions
<br /> This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the
<br /> initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C.. section
<br /> 1352 The filing of a form is required for each payment or agreement to make payment to any lobbying entity for
<br /> influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or
<br /> employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the
<br /> SF -LLL -A Continuation Sheet for additional information if the space on the form is inadequate Complete all items that
<br /> apply for both the initial filing and material change report, Refer to the implementing guidance published by the Office of
<br /> Management and Budget for additional information..
<br /> 1. Identify the type of covered Federal action for which lobbying activity is and /or has been secured to influence the
<br /> outcome of a covered Federal action
<br /> 2 Identify the status of the covered Federal action
<br /> 3. Identify the appropriate classification of this report. If this is a follow -up report caused by a material change to the
<br /> information previously reported, enter the year and quarter in which the change occurred Enter the date of the last
<br /> previously submitted report by this reporting entity for this covered Federal action
<br /> 4. Enter the full name, address, city, state and zip code of the reporting entity Include Congressional District, if known
<br /> Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub -
<br /> award recipient. Identify the tier of the subawardee, e.g.., the first subawardee of the prime is the 1st tier Subawards
<br /> include but are not limited to subcontracts, subgrants and contract awards under grants
<br /> 5.. If the organization filing the report in Item 4 checks "Subawardee ", then enter the full name, address, city, state and
<br /> zip code of the prime Federal recipient Include Congressional District, if known.
<br /> 6.. Enter the name of the Federal agency making the award or loan commitment Include at least one organizational
<br /> level below agency name, if known For example, Department of Transportation, United States Coast Guard.
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