3-Certification Regarding Lobbying.pdf
PDF 84 KB Posted
- Attached to
- Gasoline & Diesel Fuels
- Solicitation number
- ITB 250705
- Issued by
- Henderson County, Texas
About this file
This document is a Certification Regarding Lobbying form for Lubbock County, specifically for Procurement Number ITB 250705 covering Gasoline and Diesel Fuel - Annual Pricing. The form requires proposers to certify that they have not used federal appropriated funds to influence or attempt to influence government officials in connection with federal contracts, grants, loans, or cooperative agreements.
The certification requires proposers to disclose any non-federal funds used for lobbying purposes and mandates that the certification language be included in all subaward documents. Failure to file the required certification can result in civil penalties ranging from $10,000 to $100,000 for each violation. The form is to be completed, signed, and returned to the Lubbock County Director of Purchasing, with space provided for the organization's name, address, contact information, and authorized signatory details.
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Other files
| File | Type | Posted |
|---|---|---|
| 4-Cooperative Purchasing.pdf | ||
| 6-Vendor Acknowledgement.pdf | ||
| 10-Addendum 3.pdf | ||
| 9-Addendum 2.pdf | ||
| 2-Certification Regarding Energy Firearm.pdf | ||
| 7-ITB 250705 Annual Fuel.pdf | ||
| 8-Addendum 1.pdf | ||
| 1-BID Table.pdf | ||
| 5-Non-Collusive Bidding.pdf |
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Text version
CERTIFICATION REGARDING LOBBYING
(31 U.S.C.A. § 1352)
This Certification must be completed, signed, dated and returned to the Lubbock County Director of Purchasing
Procurement Number and Description: ITB 250705, GASOLINE AND DIESEL FUEL – ANNUAL
PRICING
Proposer CERTIFIES, to the best of its knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the proposer, to any person for influencing or attempting to influence an officer or employee of an 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 proposer shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions.
3. Proposer shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of the 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 this transaction imposed by 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 each such failure.
Name of Organization/Corporation: _______________________________________________________
Address: _____________________________________________________________________________
City: ____________________________ State: ___________________________ Zip Code: __________
Signature of Authorized Date
Signatory for Proposer: ______________________________________ Signed: ____________________
Title of Authorized Signatory of Proposer: __________________________________
File details come from the government source that posted it. Updated .