08 BOP-1307 Lobbying Certification Form.docx
DOCX document 93 KB Posted
- Attached to
- 12 OVR Enhanced Driving and Ancillary Services
- Solicitation number
- 6100059505
- Issued by
- Carbon County, Dauphin County, York County, Wolfdale CDP, Pennsylvania
About this file
This document is a Lobbying Certification Form required for a state and local contract opportunity 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). The contract involves procuring professional, on-demand Non-Emergency Business Transport Services for OVR employees who are blind, visually impaired, or have other disabilities that prevent them from driving themselves. The services are required for 21 total BBVS and BVRS OVR District offices located throughout the Commonwealth. Drivers may be asked to provide additional ancillary services, such as sighted guide assistance, when transporting OVR employees. Questions on the IFB must be submitted by January 15, 2024.
This is a DGS Small Business Reserve Procurement, so only self-certified small businesses are eligible to bid. Suppliers must be registered with the Commonwealth to access the bid documents. Pricing and insurance coverage for the ancillary services are required prior to contract award. The contract is for an unspecified term, likely with renewal options, to provide the requested transportation and ancillary services to OVR employees across Pennsylvania.
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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 .