06 BOP-1307 Lobbying Certification Form.docx
DOCX document 93 KB Posted
- Attached to
- 12 OVR Non-Emergency Transport Services
- Solicitation number
- 6100057835
- Issued by
- Adams County, Pennsylvania
About this file
The document provided is a Lobbying Certification Form related to a state and local contract opportunity for Non-Emergency Business Transport Services issued by the Pennsylvania Department of Labor and Industry (DLI), Office of Vocational Rehabilitation (OVR) on behalf of the Bureau of Vocational Rehabilitation Services (BVRS) and the Bureau of Blind and Visual Services (BBVS). This procurement seeks qualified transportation suppliers with the relevant experience, background, licensure, certifications, and ability to provide on-demand non-emergency business transportation services to OVR employees, some of whom may be blind, visually impaired, or have other disabilities that preclude their ability to drive themselves. The transportation services are required for the 21 total BBVS and BVRS OVR District offices located throughout the Commonwealth of Pennsylvania.
The contract opportunity is being reserved for those registered as a DGS Small Business. Suppliers are required to use the provided link to verify their status as a DGS Small Business. Any questions regarding this Invitation for Bids (IFB) must be submitted individually and in writing via email by 2pm ET on March 15, 2023, to the designated procurement resource account.
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Text version
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.gsa.gov/Forms/TrackForm/33144
(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: ________________
BOP-1307
Revised 11/7/2013 image1.png
File details come from the government source that posted it. Updated .