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DocuSign Envelope ID:675A1D41-4B16-4980-B798-628F35E22EDB
<br /> Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
<br /> penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure.
<br /> VI. Disclosure of Lobbying Activities
<br /> Instructions
<br /> This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the
<br /> initiation or receipt of a covered Federal action,or a material change to a previous filing,pursuant to title 31 U.S.C. section
<br /> 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing
<br /> or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,
<br /> or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation
<br /> Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial
<br /> filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget
<br /> for additional information.
<br /> Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the
<br /> outcome of a covered Federal action.
<br /> I. Identify the status of the covered Federal action.
<br /> 2. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the
<br /> information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
<br /> previously submitted report by this reporting entity for this covered Federal action.
<br /> 3. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known.
<br /> Check the appropriate classification of the reporting entity that designates if it is,or expects to be,a prime or sub-award
<br /> recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the 1 st tier. Subawards include
<br /> but are not limited to subcontracts, subgrants and contract awards under grants.
<br /> 4. If the organization filing the report in Item 4 checks "Subawardee",then enter the full name, address,city, state and zip
<br /> code of the prime Federal recipient. Include Congressional District, if known.
<br /> 5. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level
<br /> below agency name, if known. For example, Department of Transportation,United States Coast Guard.
<br /> 6. Enter the Federal program name or description for the covered Federal action(Item 1). If known,enter the full Catalog
<br /> of Federal Domestic Assistance(CFDA)number for grants, cooperative agreements, loans, and loan commitments.
<br /> 7. Enter the most appropriate Federal Identifying number available for the Federal action identified in Item 1 (e.g.,Request
<br /> for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant, or loan
<br /> award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-
<br /> DE-90-001."
<br /> 8. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal
<br /> amount of the award/loan commitment for the prime entity identified in Item 4 or 5.
<br /> 9. (a) Enter the full name,address,city,state and zip code of the lobbying entity engaged by the reporting entity identified
<br /> in Item 4 to influence the covered Federal action.
<br /> (b) Enter the full names of the individual(s)performing services,and include full address if different from 10(a). Enter Last
<br /> Name, First Name and Middle Initial (MI).
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