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DocuSign Envelope ID:02DCE0E9-D904-4DA8-ADBC-A8B3110E02A4
<br /> APPENDIX A, 44 C.F.R. PART 18—CERTIFICATION REGARDING LOBBYING
<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
<br /> undersigned,to any person for influencing or attempting to influence an officer or employee of
<br /> an agency, a Member of Congress, an officer or employee of Congress, or an employee of a
<br /> Member of Congress in connection with the awarding of any Federal contract, the making of
<br /> any Federal grant, the making of any Federal loan, the entering into of any cooperative
<br /> agreement, and the extension, continuation, renewal, amendment, or modification of any
<br /> 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,an officer or employee of Congress,or an employee of a Member of
<br /> Congress in connection with this Federal contract, grant, loan, or cooperative agreement,
<br /> 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,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
<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.
<br /> The Provider,Quality Inn Chapel Hill, certifies or affirms the truthfulness and accuracy of each
<br /> statement of its certification and disclosure, if any. In addition, the Provider understands and
<br /> agrees that the provisions of 31 U.S.C. Chap. 38,Administrative Remedies for False Claims and
<br /> Statements, apply to this lei fi^eA&n and disclosure, if any.
<br /> Iit,A. f jV'O k
<br /> Signature of Provider's Authorize Official
<br /> Martina Brooks, Area Director of Sales
<br /> Printed Name and Title of Provider's Authorized Official
<br /> 5/8/2020
<br /> Date
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