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<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, to
<br />any person for influencing or attempting to influence an officer or employee of an agency, a Member
<br />of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
<br />connection with the awarding of any Federal contract, the making of any Federal grant, the making
<br />of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation,
<br />renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
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<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 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.
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<br />3. The undersigned shall require that the language of this certification be included in the award documents
<br />for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans,
<br />and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
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<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, U.S. Code. Any person who fails to file the required
<br />certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for
<br />each such failure.
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<br />The Provider,Extraordinary Ventures, Inc. , 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 that
<br />the provisions of 31 U.S.C. Chap. 38, Administrative Remedies for False Claims and Statements, apply
<br />to this certification and disclosure, if any.
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<br />_________________________________________
<br />Signature of Provider’s Authorized Official
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<br />Printed Name and Title of Provider’s Authorized Official
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<br />Date
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<br />DocuSign Envelope ID: 88188806-E8CC-4364-9B03-47E3B834EFAD
<br />Extraordinary Ventures Inc.John D Rust
<br />12/14/2020
<br />Chief Operations Officer
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