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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 , AAW c4 Di51QCA0_Vo( <br />Con actor/WI A Organization (name) Program Title <br />Signature of C(id'ractor's 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 />