2018-032 Aging - TJCOG Title III fund agreement

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Attachment B: The undersigned states, that, ester -al Ceftifications 1. He or she is the duly authorized representative of the Contractor named below; 2. He or she is authorized '! to make, and does hereby make, the following certifications on behalf of the Contractor, as set out herein: a. The Certification:, Regarding: Nondjscrirninaticln; lo, The Certification, Regarding, Drug -Free Workplace Requirements; c, The Certification: Regarding Environimentall Tobacco Smoke; d, The Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tiler Covered Transactions, and el, The Certification, Regarding Lobbying; 3. He or she has comiplleted the Certification Regarding Drug-Free Workplace Requirements by pirovidingi the addresses at which the contract work will be performed; 4. [Check the applicable statement]I He or she has completed the attached Disclosure Of Lobbying Activities, because the Contractor has made, or has an agreement to make, a payment to a Ilobbyiing entity for influencing or attempting to influence an officer or employee of an agency, a Mernber of Congress, an officer or employee of Congress, or an employee of a, Member of Congress in connection with a covered Federal action; RM [X ]HIe or she has not completed the attached Discl'osuire Of Lobbying Activities because the Contractor has not made, and has no agreement to make, any payment to any lobbying entity for influencing or attempting to influence any officer or employee of any agency, any Member of Congress, any officer or employee of Congress, or any employee of a Member of Congress in connection with a covered Federal action. 5,. The Contractor shall require its subcontractors, if any, to make the same certifications and disclosure. X�I Signature (Mjrjgg_(',QUntY De - artm tit on Gratitee Name 6t'YPA'I Tifle Date I