40DHHS-S4080-Certification-regarding-lobbying.pdf
PDF 125 KB Posted
- Attached to
- Water Well Repair
- Solicitation number
- 40DHHS-S4080
- Issued by
- Nevada
About this file
This document is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, for solicitation number 40DHHS-S4080 related to a Water Well Repair project. The certification form requires the vendor to declare under oath that no Federal appropriated funds have been paid or will be paid to any person for the purpose of influencing or attempting to influence any officer or employee of a Federal agency, Member of Congress, or Congressional employee in connection with the awarding of this Federal contract or related transaction.
The form establishes that if any non-Federal funds have been or will be paid for lobbying activities in connection with this Federal contract, the vendor must complete and submit Standard Form-LLL, Disclosure of Lobbying Activities, in accordance with its instructions. Additionally, the vendor is required to include this certification language in all sub-award documents at all tiers, including subcontracts and sub-grants, and ensure all sub-recipients certify and disclose accordingly. The form notes that this certification represents a material representation of fact upon which the transaction was made and is a prerequisite for entering into the transaction, as required by Section 1352, U.S. Code. Failure to file the required certification subjects any person to civil penalties ranging from $10,000 to $100,000 for each failure. The form requires completion of fields including date, solicitation number, vendor name, authorized signer name, and authorized signature.
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Other files
| File | Type | Posted |
|---|---|---|
| 40DHHS-S4080-PREA Acknowledgement.docx | DOCX document | |
| 40DHHS-S4080 Site Visit Registration.doc | DOC document | |
| 40DHHS-S4080-Terms-and-conditions-for-services.pdf | ||
| 40DHHS-S4080-Division of Child and Family Services Fiscal Procedures.doc | DOC document | |
| 40DHHS-S4080-cost-schedule.xlsx | XLSX spreadsheet | |
| 40DHHS-S4080-Standard-form-contract.docx | DOCX document | |
| 40DHHS-S4080-Vendor-Information-Response.pdf | ||
| 40DHHS-S4080-Federal Laws and Authorities.docx | DOCX document | |
| Request for Proposal 40DHHS-S4080 Water Well Repair.docx | DOCX document | |
| 40DHHS-S4080-Insurance Schedule.docx | DOCX document | |
| Quote Instructions.pdf |
Show all 11
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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: 40DHHS-S4080 |
| Vendor name: |
| Authorized signer name: |
File details come from the government source that posted it. Updated .