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HUMEW
<br />Title 311 of the United States Code, Section 1352, entitled "Limitation on use of appropriated funds to
<br />influence certain Federal contracting and financial transactions," generally prohibits recipients, of Federal
<br />grants and cooperative agreements, from using Federal (appropriated) funds for lobbying the Executive or
<br />Legislative Branches of the Federal Government in connection with a SPECIFIC grant or cooperative
<br />agreement. Section 1352 also requires that each person who request or received a Federal grants or
<br />cooperative agreement must disclose lobbying undertaking with non-Federal (non-appropriated) funds.
<br />These requirements apply to grants and cooperative agreements EXCEEDIN 100,000 in total costs
<br />(45 CFR Part93),
<br />The Undersigned (authorized official) certifies, to the blest of his or her knowledge and belief, that:
<br />(a) No Federal appropriated fund's 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 of
<br />any agency, a member of Congress, any officer or employee of Congress, or an employee of a
<br />Member of Congress iln connection with the awarding, any Federal contract, the making of any
<br />Federal grant, the niakingi of any Federal loan, the entering into of any cooperative agreement,
<br />and the extension, continuation,, renewal, amendment, or modification of any Federal grant, loan
<br />or cooperative agreernenitp
<br />(b), If any funds other than Federal appropriated: funds have been il or will be paid to any
<br />person for influencing or attempting to influence an officer or employee of any agency, a Member
<br />of Congress, an officer or employee of Congress, or an employee of a Mernber of Congress in
<br />connection with this Federal contract, grant, loan or cooperative agreement, the undersigned
<br />shall complete and subrnit Standard Form - LLL, "Disclosure of Lobbying Activities,," in
<br />accordance with its instructions;
<br />(c) The undersigned shall require that the language of this certification be included in the award
<br />documents for all subawards at all tiers (including subcontracts, subgrants, contracts and
<br />contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify
<br />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 for making or entering into this
<br />transaction imposed by section 1352, title 31, US. Coldie, Any person who falls to file the required
<br />certification shall be subject to a civil penalty of not less than $1O,000 and not more than $l100,000 for
<br />each such failure,
<br />3. Debarment, Suspension and Other Responsibift Matters
<br />NOTE: In accordance with 45 CFR Part 76, arnended June 26, 19,95, any debarment, suspension,
<br />proposed debarment or other government wide exclusion initiated under the Federal Acquisition
<br />Regulation (FAR) on or after august 25, 19195, shall Ibe recognized by and effective for Executive Branch
<br />agencies, and participants as an exclusion under 45 CFR Part 76.
<br />The undersigned (authorized official) certifies to the best of his or her knowledge and belief, that
<br />the applicant, defined as the primary participant in accordance with 45 CFR Part 76, and its
<br />principals:
<br />(1) are not presently dleblarred, suspended, proposed for debarment, declared ineligible, or
<br />voluntarily excluded) by any Federal department or agency;
<br />(2), have not within: a 3-year period preceding this proposal been convicted of or had a civil
<br />judgment rendered against them for commission of fraud or a criminal offense in connection with
<br />obtaining, attempting to obtain, or performing a public (Federal, State, or, local) transaction or
<br />contract under a public transaction, violation of Federal or State antitrust statutes or comrnission
<br />of embezzlement, theft, forgery, bribery, falsification or destruction of records, making: false
<br />statements,, or receiving stolen property;
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