08 BOP-1307 Lobbying Certification Form.docx
DOCX document 94 KB Posted
- Attached to
- Erie OVR Enhanced Driving/Anc Svcs
- Solicitation number
- 6100065978
- Issued by
- Erie County, Pennsylvania
About this file
This is a Lobbying Certification Form required by the Commonwealth of Pennsylvania, Department of Labor and Industry, Office of Vocational Rehabilitation (OVR) for the Erie Enhanced Driving and Ancillary Services contract opportunity. The form certifies that no federal appropriated funds have been paid or will be paid to influence federal officers, members of Congress, or their employees in connection with the awarding of the contract. The certification applies to the contract itself and all sub-awards at all tiers, including subcontracts and sub-grants. Submission of this certification is a prerequisite for contract execution, and the language must be included in all award documents.
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. If any funds other than federal appropriated funds have been or will be paid to influence federal officials in connection with this contract, the bidder must complete and submit Standard Form-LLL, Disclosure of Lobbying Activities. The form requires the signature, title, and date of the certifying party and serves as a material representation of fact upon which reliance is placed when the transaction is made or entered into, pursuant to Section 1352, Title 31, U.S. Code.
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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 .