40DHHS-S4018 - Certification-regarding-lobbying.pdf
PDF 120 KB Posted
- Attached to
- Family to Family Support Services-2027
- Solicitation number
- 40DHHS-S4018
- Issued by
- Nevada
About this file
This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, on behalf of the Department of Human Services, Division of Child and Family Services (DCFS). The form pertains to a state and local contract opportunity for Family to Family Support Services for 2027, which involves Family and Youth Peer Support Services through the Children's Mental Health Services programs in Southern Nevada Child and Adolescent Services (SNCAS) and Northern Nevada Child and Adolescent Services (NNCAS). No specific details regarding quantities, response dates, due dates, site visits, bidders' meetings, award dates, or contract terms are included in this certification document.
The certification addresses lobbying compliance requirements and certifies that no federal appropriated funds have been or will be paid for lobbying activities in connection with any federal contract, grant, loan, or cooperative agreement. Vendors must disclose any non-federal funds used for lobbying purposes by submitting Standard Form-LLL and must include identical certification language in all sub-award documents. Failure to file the required certification subjects vendors to civil penalties ranging from $10,000 to $100,000 per violation. The document requires completion with the solicitation number, vendor name, authorized signer name, and date but does not specify funding amounts, pricing terms, set-asides, incumbents, or other financial details.
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Other files
| File | Type | Posted |
|---|---|---|
| Quote Instructions.pdf | ||
| 40DHHS-S4018 - Insurance Requirements.docx | DOCX document | |
| 40DHHS-S4018 - Business Associate Addendum.docx | DOCX document | |
| 40DHHS-S4018 - reference_questionnaire.docx | DOCX document | |
| 40DHHS-S4018 - Fiscal Procedures.doc | DOC document | |
| 40DHHS-S4018 - Standard-form-contract.docx | DOCX document | |
| 40DHHS-S4018 - Terms-and-conditions-for-services.pdf | ||
| 40DHHS-S4018 - Scope of Work.docx | DOCX document | |
| 40DHHS-S4018 - request-for-proposals.docx | DOCX document | |
| 40DHHS-S4018-Vendor-Information-Response.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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