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ATTACHMENT 2
<br />(Required of all Applicants, except an Indian tribe or a tribal organization)
<br />CERTIFICATION AND RESTRICTIONS ON LOBBYING
<br />I Mr. Barry Jacobs , on behalf of
<br />Name of Authorized Official
<br />Orange County
<br />Legal Name of Applicant
<br />Hereby certifies that:
<br />No Federal /State 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 Federal /State 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 Federal /State contract, the
<br />making of any Federal /State grant, the making of any Federal /State loan, the entering into of any cooperative
<br />agreement, and the extension, continuation, renewal, amendment, or modification of any Federal /State contract,
<br />grant, loan, or cooperative agreement.
<br />If any fiinds other than Federal /State appropriated funds have been paid or will be paid to any person
<br />influencing or attempting to influence an officer or employee of any Federal /State 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 Federal /State 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 certification is (,r nuweri(,rl represenotion of first upon which reliwice was ph4ced when this tlwnsaction was
<br />mile or entered into..Suhniission of `this certification is (,r prerequisite f(nr nu4king or entering into this
<br />trwisaction imposed by 31 U..& C'. §' 1 357 ((,rs (miewled by the Lohhying Disclosure Act (?f'199-5). Any person
<br />who fi,rils to file the required certification sh(,rll he subject to (,r civil petwlty of trot less thwi $10, 000 (,r id not
<br />more th(m ,5100, 000 f(nr each such fi,rilure.
<br />the utr(lersihtre(lcertifies or cff fir nis the trTuthfidness wid (occur (wy of the contents (?f the ,st(4tenietits ,sithniitte(,l (ail
<br />or with this certification wid un(,lerst(,r uls that the provisions (?f'31 U.& C'. &,ction 801, et seq., (,rre gpplic(,rhle
<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)
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