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DocuSign Envelope ID:9D2184B7-05D2-4DD9-9684-OAE766AE09DC <br /> APPENDIX A, 44 C.F.R. PART 18—CERTIFICATION REGARDING LOBBYING <br /> Certification for Contracts, Grants, Loans, and Cooperative Agreements The <br /> 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, <br /> to any person for influencing or attempting to influence an officer or employee of an agency, a <br /> Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress <br /> in connection with the awarding of any Federal contract, the making of any Federal grant, the <br /> making of any Federal loan, the entering into of any cooperative agreement, and the extension, <br /> continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or <br /> cooperative agreement. <br /> 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person <br /> for influencing or attempting to influence an officer or employee of any agency, a Member of <br /> Congress, an officer or employee of Congress, or an employee of a Member of Congress in <br /> connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned <br /> shall complete and submit Standard Form- LLL, "Disclosure Form to Report Lobbying," in <br /> 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, subgrants, and contracts under <br /> grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose <br /> 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 or <br /> entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to <br /> file the required certification shall be subject to a civil penalty of not less than $10,000 and not more <br /> than $100,000 for each such failure. <br /> The Provider, The Picnic Basket Catering, certifies or affirms the truthfulness and accuracy of each <br /> statement of its certification and disclosure, if any. In addition, the Provider understands and agrees <br /> that the provisions of 31 U.S.C. Chap. 38,Administrative Remedies for False Claims and Statements, <br /> apply to this certification and disclosure, if any. <br /> DocuSigned by: <br /> I <br /> Signature of Provider's Authorized Official <br /> Erik Dailey President <br /> 13 <br />