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CERTIFICATION REGARDING LOBBYING <br /> Certification for Contracts,Grants,Loans, <br /> and Cooperative Agreements <br /> The undersigned certifies,to the best of his or her knowledge and belief,that: <br /> (1) 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 an officer or employee <br /> of Congress, or an employee of a Member of Congress in connection with the awarding of <br /> any Federal 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,of modification of any Federal contract, grant loan,or cooperative agreement. <br /> (2) If any funds other than Federal appropriated funds have been paid or will be paid to any <br /> person for influencing or attempting to influence an officer or employee of any agency, a <br /> Member of Congress in connection with this Federal contract, grant, loan, or cooperative <br /> agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure <br /> Form to Report Lobbying," in accordance with its instructions. <br /> (3) The undersigned shall require that the language of this certification be included in the award <br /> documents for all* sub-awards at all tiers (including subcontracts, sub-grants and contracts <br /> under grants, loans, and cooperative agreements) and that all* sub-recipients shall certify <br /> and disclose accordingly. <br /> This certification is a material representation of fact upon which reliance was placed when this <br /> transaction was made or entered into. Submission of this certification is a prerequisite for making <br /> or entering into 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 of not less than $10,000 and <br /> not more than$100,000 for each such failure. C p <br /> Q(R n Q AWV qk ,�a� SQY CQ.. i'�� r� �, \fa rR <br /> � 4(aWl <br /> Contractor/WIO Organization(name) Program Title <br /> Signature of Contrifitoes Certifying Official Date <br /> *NOTE: In these instances, "All," in the Final Rule is expected to be clarified to show that it <br /> applies to covered contract/grant transactions over$100,000(per OMB). <br /> Regional Partnership Workforce Development Board <br /> (Rev.6/7/17) Page 22 <br />