5-Form - Lobbying.pdf
PDF 68 KB Posted
- Attached to
- Round Island Shelters Columns Replacement
- Solicitation number
- 2027006
- Issued by
- Indian River County, Wilton Manors City, Florida
About this file
This is a Certification Regarding Lobbying form required for submission with the Round Island Shelters Columns Replacement project in Vero Beach, Florida. The project involves replacing thirty deteriorated poured-concrete structural columns across five existing picnic pavilions at Round Island Park, with six columns per pavilion. All work must comply with approved construction plans, issued permits, Florida Building Code requirements, and all applicable federal, state, and local regulations. The contractor must provide all labor, supervision, materials, equipment, temporary supports, disposal, testing, protection, and incidental services necessary to complete the replacement work.
This certification form must be submitted with any bid or offer exceeding $100,000 or any bid that may be paid for under a FEMA PA Grant. The contractor certifies that no federal appropriated funds have been or will be paid to influence federal officials in connection with the contract award. If non-federal funds are used for lobbying purposes, the contractor must submit Standard Form-LLL. The contractor must also include this certification language in all subaward documents and require subrecipients to certify and disclose accordingly. Failure to submit the required certification subjects the contractor to civil penalties between $10,000 and $100,000 for each failure. The certification is a material representation of fact and a prerequisite for contract execution, with compliance governed by 31 U.S.C. § 1352 and § 3801 et seq.
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Text version
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
(This form MUST be submitted with each bid or offer exceeding $100,000, as well as with any bid or offer that may be paid for under FEMA PA Grant)
The undersigned Contractor certifies, to the best of his or her knowledge, 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 an 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 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 Form to Report Lobbying,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients 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 31, U.S.C. § 1352. 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.
The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any.
Signature of Contractor’s Authorized Official
Name and Title of Contractor’s Authorized Official
Date
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