15COE-S3567 Certification-regarding-lobbying.pdf

PDF 120 KB Posted

Attached to
Case Management System
Solicitation number
15COE-S3567
Issued by
Nevada

About this file

This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, applicable to the Case Management System procurement for the State of Nevada. The form serves as a mandatory certification requirement for vendors responding to this state and local contract opportunity. Bidders must certify their compliance with federal regulations prohibiting the use of appropriated funds for lobbying activities related to federal contracts, grants, loans, and cooperative agreements. The form requires vendors to provide their organization name, authorized signer name and signature, the solicitation number, and the date of submission as part of the bid response documentation.

This certification form is a material representation of fact required by section 1352 of U.S. Code and must be completed and submitted as a prerequisite for contract award. Vendors certify that no federal appropriated funds have been or will be paid to influence federal agency officers, congressional members, or their employees in connection with this transaction. If non-federal funds have been used for lobbying purposes, vendors must submit Standard Form-LLL disclosing such activities. All subcontractors, sub-awardees, and sub-recipients at all tiers must be required to provide the same certification and disclosure. Failure to file the required certification subjects the vendor to civil penalties ranging from $10,000 to $100,000 for each violation.

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15COE-S3567 Strategic Plan.pdf PDF
15COE-S3567-reference-questionnaire.docx DOCX document
15COE-S3567 Insurance Requirements.docx DOCX document
Quote Instructions.pdf PDF
15COE-S3567 Cost Schedule.docx DOCX document
15COE-S3567-Vendor-Information-Response.pdf PDF
15COE-S3567 Terms-and-conditions-for-services.pdf PDF
15COE-S3567 Standard-form-contract.docx DOCX document
15COE-S3567 RFP.v2~2.docx DOCX document

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Nevada State Purchasing Division Department of Administration 515 E Musser St Ste 300 Carson City, NV 89701 purchasing.nv.gov nevadaepro.com

Revised 2024-10 Page 1 of 1

Certification regarding lobbying

The undersigned certifies, to the best of his or her knowledge and belief, that:

1. No Federal appropriated funds have been paid or shall 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 Federally appropriated funds have been paid or shall 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,” in accordance with its instructions.

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 by section 1352, 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 each such failure.

Date

Solicitation number

Vendor Name

Authorized signer name

Authorized signature https://purchasing.nv.gov/ https://nevadaepro.com/

Date:
Solicitation number:
Vendor name:
Authorized signer name:

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