40DHHS-S3649-Certification-regarding-lobbying.pdf
PDF 120 KB Posted
- Solicitation number
- 40DHHS-S3649
- Issued by
- Clark County, Nevada
About this file
This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, for use in connection with a Transportation Services for Children in Clark County solicitation managed by the Department of Human Services, Division of Child and Family Services. The form requires vendors to certify that no Federal appropriated funds have been or will be paid to influence government officials in connection with the Federal contract award. Vendors must also certify their commitment to including equivalent certification language in all sub awards and requiring sub recipients to certify and disclose accordingly.
The certification constitutes a material representation of fact and is a prerequisite for contract execution as mandated by Section 1352, U.S. Code. Non-compliance with the certification requirement subjects vendors to civil penalties ranging from $10,000 to $100,000 for each failure. The form requires completion with the solicitation number, vendor name, authorized signer name, authorized signature, and date prior to submission.
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Other files
| File | Type | Posted |
|---|---|---|
| 40DHHS-S3649-reference-questionnaire.docx | DOCX document | |
| Terms-and-conditions-for-services~26.pdf | ||
| 40DHHS-S3649-Attachment 4- State Holidays.pdf | ||
| 40DHHS-S3649-RFP_Transportation Services for Children in Clark County.docx | DOCX document | |
| 40DHHS-S3649-Insurance Schedule.docx | DOCX document | |
| Attachment B- Confidentiality Addendum.docx | DOCX document | |
| Updated-40DHHS-S3649-RFP_Transportation Services for Children in Clark County.docx | DOCX document | |
| Attachment C- Fiscal Procedures.docx | DOCX document | |
| Quote Instructions.pdf | ||
| 40DHHS-S3649-Cost Schedule.docx | DOCX document | |
| Standard-form-contract~19.docx | DOCX document | |
| 40DHHS-S3649-Attachment 1- Route Example.pdf | ||
| 40DHHS-S3649-SOW- Transportation RFP.docx | DOCX document | |
| 40DHHS-S3649-Vendor-Information-Response.pdf | ||
| 40DHHS-S3649-Attachment 3- Route Example.pdf | ||
| Attachment A - Federal Laws and Authorities.docx | DOCX document | |
| 40DHHS-S3649-Attachment 2- Route Example.pdf | ||
| 40DHHS-S3649 Bid Questions and Answers.pdf |
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Text version
Nevada State Purchasing Division Department of Administration 515 E Musser St Ste 300 Carson City, NV 89701 purchasing.nv.gov nevadaepro.com
Revised 2024-10 Page 1 of 1
Certification 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 shall be paid, by or on behalf of the undersigned, 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 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 Federally appropriated funds have been paid or shall 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 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 sub awards at all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative agreements) and that all sub recipients 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, 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.
Date
Solicitation number
Vendor Name
Authorized signer name
Authorized signature https://purchasing.nv.gov/ https://nevadaepro.com/
| Date: |
| Solicitation number: |
| Vendor name: |
| Authorized signer name: |
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