05 Lobbying Cert Form.pdf
PDF 169 KB Posted
- Attached to
- Emergency Care Services
- Solicitation number
- 4400030450
- Issued by
- Pennsylvania
About this file
The document provided is a Lobbying Certification Form that outlines requirements for contractors and sub-recipients to disclose any lobbying activities related to federal contracts, grants, loans, or cooperative agreements. The purpose is to ensure transparency and compliance with federal regulations.
The related state and local contract opportunity is for Emergency Care Services in the state of Pennsylvania. This Invitation to Qualify (ITQ) is intended to qualify contractors to provide turnkey congregate sheltering services and large-scale feeding operations in response to emergencies or Governor-declared disasters when local resources are exceeded. Suppliers must register in the PA Supplier Portal and create a user profile in the JAGGAER portal to complete the qualification requirements, which will only be accepted electronically through JAGGAER. Technical support is available through JAGGAER.
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Text version
BOP-1307
Revised 11/7/2013
LOBBYING CERTIFICATION FORM
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure of Lobbying Activities, which can be found at:
https://www.epa.gov/sites/default/files/2020-06/documents/sflll_1_2-v1.2_fill-sign.pdf
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed under Section 1352, Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for such failure.
SIGNATURE: ______________________________________________________________
TITLE: _____________________________________________ DATE: ________________
https://www.epa.gov/sites/default/files/2020-06/documents/sflll_1_2-v1.2_fill-sign.pdf
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