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16 <br /> <br /> <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 /> <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 /> <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 /> <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 /> <br />The Provider, Southern Harvest and Q Shack Catering, certifies or affirms the truthfulness and <br />accuracy of each statement of its certification and disclosure, if any. In addition, the Provider <br />understands and agrees that the provisions of 31 U.S.C. Chap. 38, Administrative Remedies for False <br />Claims and Statements, apply to this certification and disclosure, if any. <br /> <br />_________________________________________ <br />Signature of Provider’s Authorized Official <br /> <br /> <br /> Printed Name and Title of Provider’s Authorized Official <br /> <br /> <br />Date <br /> <br /> <br />DocuSign Envelope ID: 46AAA209-37F8-4264-B691-2868C8B31BDA <br />Rachelle Howard <br />12/13/2021