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7 <br /> ATTACHMENT A <br /> LOBBYING PROHIBITION <br /> The undersigned certifies,to the best of his or her knowledge and belief,that: <br /> (a) No Federal appropriated funds have been paid or will be paid,by or on behalf of the <br /> undersigned,to any person for influencing or attempting to influence either directly <br /> or indirectly an officer or employee of any State or Federal agency, a member of the <br /> N.C. Legislature, a Member of Congress, an officer or employee of Congress,or an <br /> employee of a Member of Congress in connection with the awarding of any Federal <br /> contract,the making of any Federal grant,the making of any Federal loan,the <br /> entering into of any cooperative agreement, and the extension, continuation,renewal, <br /> amendment, or modification of any Federal contract, grant,loan, or cooperative <br /> agreement. <br /> (b) If any funds other than Federal appropriated funds have been paid or will be paid to <br /> any person for influencing or attempting to influence-an officer or employee of any <br /> agency, a Member of Congress, an officer or employee of Congress,or an employee <br /> of a Member of Congress in connection with this Federal contract,grant,loan or <br /> cooperative agreement,the undersigned shall complete and submit Standard Form-L. <br /> "Disclosure Form to Report Lobbying,"in accordance with its instructions. <br /> (c) The undersigned shall require that the language of this certification be included in the <br /> award documents for all sub-awards at all tiers (including subcontracts, sub-grants, <br /> and contracts under grants, loans, and cooperative agreements) and that all recipients <br /> of funds under this Agreement shall certify and disclose accordingly. <br /> This certification is a material representation of fact upon which reliance was placed when <br /> this transaction was made or entered into. Submission of this certification is a prerequisite for <br /> making or entering into this transaction imposed by section 1352,title 31,U.S. Code. Any person <br /> who fails to file the required certification shall be subject to a civil penalty of not less than <br /> $10,000 and not more than$100,000 for each failure. <br /> Name of Applicant <br /> BY: <br /> Signature of Applicant's Designated Agent <br /> Reviewed 10/23/2012 _ Page 5 of 7 Rev.06/02 <br />