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34 <br /> RD Instruction 1940-Q <br /> Exhibit A-1 <br /> CERTIFICATION FOR CONTRACTS, GRANTS AND LOANS <br /> The undersigned certifies, to the best of his or her knowledge and belief, <br /> that: <br /> 1. No Federal appropriated funds have been paid or will be paid, by or <br /> on behalf of the undersigned, to any person for influencing or attempting to <br /> influence an officer or employee of any agency, a Member of Congress, an <br /> officer or employee of Congress, or an employee of a Member of Congress in <br /> connection with the awarding of any Federal contract, the making of any <br /> Federal grant or Federal loan, and the extension, continuation, renewal, <br /> amendment, or modification of any Federal contract, grant or loan. <br /> 2. If any funds other than Federal appropriated funds have been paid or <br /> will be paid to any person for influencing or attempting to influence an <br /> officer or employee of any agency, a Member of Congress, an officer or <br /> employee of Congress, or an employee of a Member of Congress in connection <br /> with this Federal contract, grant or loan, the undersigned shall complete and <br /> submit Standard Form -- LLL, "Disclosure of Lobbying Activities, " in accordance <br /> with its instructions. <br /> 3. The undersigned shall require that the language of this certification <br /> be included in the award documents for all subawards at all tiers (including <br /> contracts, subcontracts, and subgrants under grants and loans) and that all <br /> subrecipients shall certify and disclose accordingly. <br /> This certification is a material representation of fact upon which <br /> reliance was placed when this transaction was made or entered into. <br /> Submission of this certification is a prerequisite for making or entering into <br /> this transaction imposed by section 1352, title 31, U.S. Code. Any person who <br /> fails to file the required certification shall be subject to a civil penalty <br /> of not less than $10, 000 and not more than $100,000 for each such failure. <br /> (name) (date) <br /> (title) <br /> oOo <br /> (08-21-91) PN 171 <br />