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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 funds 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 />llrrs is a Inater ial r ej)rprssrsnlalr()tr which rprslrcrnce was placed when this was
<br />rnade ()rp entered XrrbInissh.wi, (?f lhrs is cr prerpequisile ,,)rp rncrkin,,, /. ()rp enterin,,," rnhr this
<br />trpertrsa,th.wi, rr rj)(),yed by 31 / /aXC e� >° 1352 ('(Is altlended by the ,()/r/ryrn,s,y Drsch') ureAr;t 1995,)e Any pers(') r
<br />wh( ,).fcrrls ter rle tdrrs rprs uir ed shall be srr /r P�s�rcrlty � y� �r��t lrs� � tdrer�r � d ll tytyll �r�rr/ �r�rt
<br />r�r�rrp s than $100,000, fiV each such firrlrrre
<br />h,e rrndersi""' trrsr/ r;rsrptr rrss ()rp qffirltls the trputdr rrinrss and crr,r urperr,y y °tdrrs r,(wrtrsnt y the stcrtrsrtrrstrty err /rrtrrttrsr/ (,)n
<br />()rp with this that theprp()vr,yr()n,y (?1'31 /. /aX C� 3801, eI seqs , are al)l licable
<br />lher el(t ,)e
<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 />
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