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MEW <br />Schedule H <br />Federal Certification Regarding Lobbying <br />(Required of Governmental Agencies and Non-Profit Organizations) <br />The undersigned certifies, ho the best of his orher knowledge and belief, that: <br />/'1\ No Federal '' ' funds have been <br />paid or will bo paid bxoron behalf of the undersigned, <br />to o ` person for influencing or attempting to influence an#fficaror employee of any agency, aMember <br />of "ong naoa , en officer oremployee of Congremo . oron employee ofa Member of Congress inconnection <br />with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal <br />loan, the anterinQinto of any cooperative agreement, and the extension, continuation, renewal, <br />amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. <br />/2\ |f any funds other thenFedora|approor�todfundohevebeenoo�ormdUbopaidtoonyperoon <br />for ` 'influoOcingorathsmcdinQtoinOusnmaoncfUmarorernp|oyeeofanyogancy.aKAeDmberof<�onQreoa. <br />onoMicaroremp|oyae' Congress, oron employee ofe Member of Congress in connection with this <br />Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit <br />Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. <br />/3\ The undersigned ohmUrequire that the language of this nertUDooUonbe included in the award <br />''curnentsfora||eubaxvandnoto||t|ero(inn|udingnubcontrooto'oubgmanto.andoontnactaundergnsnba. <br />loans, and cooperative agreements) and that all subreciplents; shall certify and disclose accordingly. <br />This certification is a material representation of fact upon which reliance was placed when this transaction <br />was made or entered into. Submission of this certification is a prerequisite foe making or entering into this <br />transaction imposed by. Section 1352. Title 31.U.S.Code. Any person who fails to file the required <br />certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for <br />each such failure. <br />Signature Title <br />let PJ <br />Agencyl6rganimition Date <br />(Certification signature ahou|dboaonmaanContnactoignetuns.) <br />Schedule H— Page }of1 <br />