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• 8022.1 <br /> • 43 <br /> Appendix 12c <br /> RESTRICTIONS ON LOBBYING - CERTIFICATION <br /> By submitting 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 Member 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 /> caking 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, •Disclosure Form to Report <br /> Lobbying,* in accordance with its instructions. 1% <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, 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 />