375-030-33-DISCLOSE_OF_LOBBY_ACTIVITIES.pdf
PDF 17 KB Posted
- Attached to
- Meter Changeout Supplies State and local contract opportunity
- Solicitation number
- 25-046-ITB
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
The document is a Procurement Certification for Disclosure of Lobbying Activities form issued by the State of Florida Department of Transportation (FDOT), specifically form 375-030-33, designed to comply with federal regulations regarding lobbying activities on federal-aid contracts. The form requires prospective participants to certify that they have not used federal appropriated funds to influence or attempt to influence federal officials, members of Congress, or their employees in connection with federal contracts, grants, loans, or cooperative agreements.
The certification mandates that if any non-federal funds have been used for lobbying purposes, the participant must complete and submit a Standard Form-LLL "Disclosure of Lobbying Activities". Failure to file the required certification can result in civil penalties ranging from $10,000 to $100,000 for each violation. The form also requires participants to include similar certification language in all lower-tier subcontracts exceeding $100,000, ensuring transparency and compliance with federal lobbying disclosure requirements.
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Text version
375-030-33
10/01
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
PROCUREMENT CERTIFICATION FOR DISCLOSURE OF LOBBYING ACTIVITIES
ON FEDERAL-AID CONTRACTS
(Compliance with 49CFR, Section 20.100 (b))
The prospective participant certifies, by signing this certification, that to the best of his or her knowledge and belief:
(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 federal 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 federal 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.
(Standard Form-LLL can be obtained from the Florida Department of Transportation's Professional Services Administrator or Procurement Office.)
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, 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.
The prospective participant also agrees by submitting his or her proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly.
Name of Consultant:
By: Date:
Authorized Signature:
Title:
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