4-f. Certificate Regarding Lobbying.pdf
PDF 165 KB Posted
- Attached to
- Gasoline
- Solicitation number
- IFB No. 26-09 Gasoline
- Issued by
- Rock Island County, Illinois
About this file
This document is a Certificate Regarding Lobbying form issued by the Illinois State Board of Education located in Springfield, IL. The form requires an authorized representative of an organization to certify that no federal appropriated funds have been or will be paid to influence or attempt to influence any government officials in connection with federal contracts, grants, loans, or cooperative agreements.
The certification requires the organization to disclose any non-federal funds used for lobbying activities by completing a separate "Disclosure of Lobbying Activities" form (ISBE 85-37). The document warns that failure to file the required certification can result in civil penalties ranging from $10,000 to $100,000 for each violation. The form must be signed by an authorized representative who will include the organization name, PR/Award number or project name, representative name, title, and date.
View the file
Other files
Show all 11
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ILLINOIS STATE BOARD OF EDUCATION
100 North First Street
Springfield, IL 62777-0001
CERTIFICATE 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 will be paid, by or on behalf of the undersigned, 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 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 ISBE 85-37, “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 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 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.
Organization Name
PR/Award Number or Project Name
Name of Authorized Representative
Title
Original Signature of Authorized Representative
Date
Only change was moving up the signature area.
File details come from the government source that posted it. Updated .