4-Lobbying Certification.pdf

This document is a Certification Regarding Lobbying form for federal contracts, grants, loans, and cooperative agreements. The form requires the signatory to certify that no federal appropriated funds have been or will be paid to influence or attempt to influence any federal agency, member of Congress, or government employee in connection with the award of a federal contract, grant, loan, or cooperative agreement.

The certification includes critical legal stipulations, such as requiring the language of this certification to be included in award documents, subcontracts, and all related agreements. If any non-federal funds have been used to attempt to influence government officials, the organization must disclose this information. Failure to file the required certification exposes the organization to potential civil penalties of up to $100,000 for each violation. The form provides space for the organization name, award number or project name, authorized representative details, signature, and date of execution.