Orange County NC Website
Browse       Search
<br /> <br />CERTIFICATION REGARDING LOBBYING <br /> <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 <br />employee of any 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 />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 <br />contract, grant, loan, or cooperative agreement. <br /> <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 of a <br />Member of Congress in connection with this Federal contract, grant, loan, or cooperative <br />agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure <br />of Lobbying Activities," in accordance with its instructions. <br /> <br />(3) The undersigned shall require that the language of this certification be included in <br />the award documents of all sub-awards at all tiers (including subcontracts, sub-grants, <br />and contracts under grants, loans, and cooperative agreements) and that all sub- <br />recipients shall certify and disclose accordingly. <br /> <br />This certification is a material representation of fact upon which reliance was placed <br />when this transaction was made or entered into. Submission of this certification is a <br />prerequisite for making or entering into this transaction imposed by section 1352, title <br />31, United States Code. Any person who fails to file the required certification shall be <br />subject to a civil penalty of not less than $10,000 and not more than $100,000 for each <br />such failure. <br /> <br /> <br /> <br />Organization: <br /> <br /> <br />Street address: <br /> <br /> <br />City, State, Zip: <br /> <br /> <br /> <br />CERTIFIED BY:(type or print) <br /> <br /> <br />TITLE: <br /> <br /> <br /> (signature) (date) <br />Docusign Envelope ID: CF064D56-F89A-8651-8229-D168AFF8B909