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DocuSign Envelope ID: A07C4620 -D9F0- 4228- 9B2F- lD499E5F8796
<br />ATTACHMENT G
<br />CERTIFICATION REGARDING LOBBYING
<br />Orange County Department of Social Services and Department on Aging
<br />Certification for Contracts, Grants, Loans 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 undersigned, to
<br />any person for influencing or attempting to influence an officer or employee of any Federal, state or
<br />local government agency, a Member of Congress, a Member of the General Assembly, an officer or
<br />employee of Congress, an officer or employee of the General Assembly, an employee of a Member
<br />of Congress, or an employee of a Member of the General Assembly in connection with the awarding
<br />of any Federal or state contract, the making of any Federal or state grant, the making of any Federal
<br />or state loan, the entering into of any cooperative agreement, and the extension, continuation,
<br />renewal, amendment, or modification of any Federal or state contract, grant, loan, or cooperative
<br />agreement.
<br />(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
<br />influencing or attempting to influence an officer or employee of any Federal, state or local
<br />government agency, a Member of Congress, a Member of the General Assembly, an officer or
<br />employee of Congress, an officer or employee of the General Assembly, an employee of a Member
<br />of Congress, or an employee of a Member of the General Assembly in connection with the awarding
<br />of any Federal or state contract, the making of any Federal or state grant, the making of any Federal
<br />or state loan, the entering into of any cooperative agreement, and the extension, continuation,
<br />renewal, amendment, or modification of any Federal or state contract, grant, loan, or cooperative
<br />agreement; the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to
<br />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 subawards at all tiers (including subcontracts, shbgrants, and contracts under
<br />grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose
<br />accordingly.
<br />(4) 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 or
<br />entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails
<br />to file the required certification shall be subject to a civil penalty of not less than $10,000 and not
<br />more than $100,000 for each such failure.
<br />Notwithstanding other provisions of federal OMB Circulars -CFR Title 2, Grants and Agreements, Part 200,
<br />costs associated with the following activities are unallowable:
<br />Paragraph A.
<br />(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
<br />similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
<br />(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign,
<br />political action committee, or other organization established for the purpose of influencing the
<br />outcomes of elections;
<br />(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
<br />modification of any pending Federal or State legislation through communication with any member
<br />or employee of the Congress or State legislature (including efforts to influence State or local
<br />Federal Certification — Lobbying (06/15) Pagel of 3
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