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<br /> Exhibit D
<br /> APPENDIX A,44 C.F.R.PART 18—CERTIFICATION REGARDING
<br /> 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
<br /> employee of an agency, a Member of Congress, an officer or employee of Congress, or
<br /> an employee of a Member of Congress in connection with the awarding of any Federal
<br /> contract, the making of any Federal grant, the making of any Federal loan, the entering
<br /> into of any cooperative agreement, and the extension, continuation,renewal,
<br /> amendment, or modification of any Federal 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
<br /> any person for influencing or attempting to influence an officer or employee of any
<br /> agency, a Member of Congress, an officer or employee of Congress, or an employee
<br /> of a Member of Congress in connection with this Federal contract, grant, loan, or
<br /> cooperative agreement, the undersigned shall complete and submit Standard Form-
<br /> LLL, "Disclosure Form to Report Lobbying,"in accordance with its instructions.
<br /> 3. The undersigned shall require that the language of this certification be included in the
<br /> award documents for all subawards at all tiers (including subcontracts, subgrants, and
<br /> contracts under grants, loans, and cooperative agreements) and that all subrecipients
<br /> shall certify and disclose accordingly.
<br /> This certification is a material representation of fact upon which reliance was placed
<br /> when this transaction was made or entered into.Submission ofthis certification is a
<br /> prerequisite formaking or entering into this transaction imposed by section 1352, title
<br /> 31, U.S. Code. Any person who fails to file the required certification shall be subject to a
<br /> civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
<br /> The Subrecipient, White Cross Volunteer Fire Department, certifies or affirms the
<br /> truthfulness and accuracy of each statement of its certification and disclosure, if any. In
<br /> addition,the Subrecipient understands and agrees that the provisions of 31 U.S.C.
<br /> Chap. 38, Administrative Remedies for False Claims and Statements, apply to this
<br /> certification and disclosure, if any.
<br /> Signature of Subrecipient's Authorized Official Date
<br /> Print Name, Title of Subrecipient's Authorized Official
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