4-Form - Lobbying.pdf
PDF 68 KB Posted
- Attached to
- Annual Bid for Liquid Carbon Dioxide
- Solicitation number
- 2026023
- Issued by
- Indian River County, Florida
About this file
This is a Certification Regarding Lobbying form, which is a federal compliance document required for state and local contract opportunities in Florida that exceed $100,000 or may be funded under FEMA Public Assistance grants. The form applies to the Annual Bid for Liquid Carbon Dioxide, which requires contractors to furnish and deliver liquid carbon dioxide. The certification must be submitted with each bid or offer and serves as a prerequisite for contract award. The document establishes the contractor's obligation to comply with federal regulations regarding lobbying activities and disclosure requirements.
The certification requires the contractor to affirm that no federal appropriated funds have been or will be paid to influence federal officials or Congress members in connection with the contract award. If non-federal funds have been or will be used for lobbying purposes, the contractor must complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying." The contractor must also ensure that all subcontractors and subrecipients at all tiers include identical certification language in their award documents and provide corresponding certifications and disclosures. Failure to submit the required certification subjects the contractor to civil penalties ranging from $10,000 to $100,000 per violation. The certification is governed by 31 U.S.C. Section 1352 and Section 3801 et seq., and must be signed by an authorized official of the contractor.
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Text version
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
(This form MUST be submitted with each bid or offer exceeding $100,000, as well as with any bid or offer that may be paid for under FEMA PA Grant)
The undersigned Contractor certifies, to the best of his or her knowledge, 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 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 Form to Report Lobbying,” 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 31, U.S.C. § 1352. 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 Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any.
Signature of Contractor’s Authorized Official
Name and Title of Contractor’s Authorized Official
Date
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