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<br />State Centric MOA 4393-0083-F Orange County
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<br />ATTACHMENT C : CERTIFICATION REGARDING LOBBYING (Appendix
<br />A, 44 C.F.R. Part 18)
<br />
<br />Certification for Contracts, Grants, Loans, and Cooperative Agreements
<br />
<br />The undersigned certifies, to the best of his or her knowledge and belief, that:
<br />
<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 any
<br />Federal grant, the making of any Federal loan, the entering into of any cooperative agreement,
<br />and the extension, continuation, renewal, amendment, or modification of any Federal contract,
<br />grant, loan, or cooperative agreement.
<br />
<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, the
<br />undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report
<br />Lobbying,” in 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
<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
<br />and not more than $100,000 for each such failure.
<br />
<br />The RECIPIENT/SUBGRANTEE, Sarah Pickhardt, certifies or affirms the truthfulness and
<br />accuracy of each statement of its certification and disclosure, if any. In addition, the
<br />RECIPIENT/SUBGRANTEE understands and agrees that the provisions of 31 U.S.C. Chap. 38,
<br />Administrative Remedies for False Claims and Statements, apply to this certification and
<br />disclosure, if any.
<br />
<br />_________________________________________________________________
<br />Signature of RECIPIENT/SUBGRANTEE’s Authorized Official
<br />SARAH PICKHARDT, DIVISION CHIEF OF EMERGENCY MANAGEMENT
<br />Name and Title of RECIPIENT/SUBGRANTEE’s Authorized Official
<br />_______________
<br />Date
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<br />DocuSign Envelope ID: 9080716C-121D-4F19-9E12-FB2684335DF5DocuSign Envelope ID: A02EDAA0-6072-4731-9C1B-857DF9D747A3
<br />6/1/2023 | 13:22:39 EDT
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