4a Certification Regarding Lobbying Form.pdf
PDF 14 KB Posted
- Attached to
- Electrician Services State and local contract opportunity
- Solicitation number
- 25-02-SP
- Issued by
- Santa Rosa County, Florida
About this file
This document is a Certification Regarding Lobbying form, which is a federal compliance document designed to prevent improper lobbying activities in connection with federal grants, contracts, loans, and cooperative agreements. The certification requires the undersigned organization to affirm that no federal appropriated funds have been or will be paid to influence any government officials or members of Congress in relation to awarding federal financial assistance or contracts.
The form outlines specific requirements for organizations, including mandatory disclosure of any non-federal funds used for lobbying purposes by submitting Standard Form-LLL and ensuring that sub-recipients at all tiers include similar language in their award documents. Failure to comply with this certification can result in significant civil penalties, ranging from $10,000 to $100,000 for each violation. The document provides blank fields for an organization to complete, including organization name, address, and certification details, and requires an authorized representative's signature and title.
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Text version
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 will 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 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 Federal appropriated funds have been paid or will 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 of 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, title 31, United States 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.
Organization:
Street address:
City, State, Zip:
CERTIFIED BY:
(type or print)
TITLE:
(signature) (date)
| Organization: |
| Street address: |
| City State Zip: |
| type or print: |
| TITLE: |
| date: |
File details come from the government source that posted it. Updated .