40DHHS-S4053-Certification-regarding-lobbying.pdf
PDF 120 KB Posted
- Attached to
- Water Well Repair
- Solicitation number
- 40DHHS-S4053
- Issued by
- Elko 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 Water Well Repair contract opportunity in Elko, Nevada. The form serves as a mandatory certification that bidders and contractors must complete and submit as a prerequisite to award. The document requires the authorized representative of the vendor to certify compliance with federal lobbying restrictions and to acknowledge understanding of disclosure requirements for any non-federally appropriated funds used for lobbying activities related to the contract award.
The certification mandates that no federal appropriated funds have been or shall be paid to influence federal officials or members of Congress in connection with the contract award. Should non-federal funds be used for such purposes, the vendor must complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with federal instructions. Additionally, all sub-recipients, subcontractors, and sub-grantees must be required to include this certification language in their award documents and certify compliance accordingly. Failure to file the required certification subjects the responsible party to civil penalties ranging from a minimum of $10,000 to a maximum of $100,000 for each violation, with the certification serving as a material representation of fact upon which the transaction is based, as required by section 1352 of U.S. Code.
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Other files
| File | Type | Posted |
|---|---|---|
| 40DHHS-S4053-Federal Laws and Authorities.docx | DOCX document | |
| 40DHHS-S4035-cost-schedule.xlsx | XLSX spreadsheet | |
| 40DHHS-S4053-Terms-and-conditions-for-services.pdf | ||
| 40DHHS-S4053-Vendor-Information-Response.pdf | ||
| 40DHHS-S4053-Insurance Schedule.docx | DOCX document | |
| Quote Instructions.pdf | ||
| Request for Proposal 40DHHS-S4053 Water Well Repair.docx | DOCX document | |
| 40DHHS-S4053-Standard-form-contract.docx | DOCX document | |
| 40DHHS-S4053-PREA Acknowledgement.docx | DOCX document | |
| 40DHHS-S4053-Division of Child and Family Services Fiscal Procedures.doc | DOC document |
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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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