08 BOP-1307 Lobbying Certification Form.docx
DOCX document 94 KB Posted
- Attached to
- Allegheny OVR Enhanced Driving/Anc Svcs
- Solicitation number
- 6100066394
- Issued by
- Allegheny County, Philadelphia City, Pennsylvania
About this file
This is a Lobbying Certification Form associated with a Pennsylvania Department of Labor and Industry, Office of Vocational Rehabilitation (OVR) procurement for Non-Emergency Transport Services in Allegheny County. The form certifies compliance with federal lobbying restrictions and is required for the Invitation to Bid (IFB) 6100061271 for OVR Allegheny Enhanced Driving and Ancillary Services. The services involve transporting Office of Vocational Rehabilitation employees and passengers who are blind, visually impaired, or have other disabilities that preclude their ability to drive themselves. Transportation is generally expected to originate from the Pittsburgh BVRS/BBVS OVR District office to locations where Commonwealth business is performed, with the exception of initial work assignments where the employee's location may be closer to the destination. The procurement includes both ambulatory transports for personnel with disabilities who can walk but cannot safely operate a motor vehicle, and non-ambulatory transports for personnel requiring wheelchair or motorized scooter transportation.
The procurement is reserved exclusively for Department of General Services (DGS) Small Businesses, requiring bidders to attach their Small Business Certificate to be deemed eligible. Bidders may self-certify through the Small Business Contracting program at www.dgs.pa.gov/bdisbo. The form itself is a material representation of fact certifying that no federal appropriated funds have been or will be paid to influence government officials in connection with this contract award, and that any non-federal funds used for lobbying purposes will be disclosed on Standard Form-LLL. Failure to file the required certification subjects violators to civil penalties ranging from $10,000 to $100,000. All sub-recipients and sub-awards at all tiers must include equivalent lobbying certification language in their award documents.
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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 .