55AGR-S3574 PIZZA Certification-regarding-lobbying.pdf
PDF 120 KB Posted
- Attached to
- CLIC's Software System
- Solicitation number
- 40DHHS-S3547
- Issued by
- Churchill County, Nevada
About this file
This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, for solicitation 55AGR-S3574 PIZZA. The form certifies that no Federal appropriated funds have been paid or will be paid by the vendor to influence any officer or employee of a Federal agency, Member of Congress, or Congressional employee in connection with the awarding of Federal contracts, grants, loans, or cooperative agreements. The document requires vendors to complete and submit Standard Form-LLL, Disclosure of Lobbying Activities, if any non-Federal funds have been or will be paid for influencing purposes related to this Federal transaction.
The certification must be included in all award documents for sub awards at all tiers, including subcontracts and sub grants, with all sub recipients required to certify and disclose accordingly. The form serves as a material representation of fact and is a prerequisite for entering into the transaction under section 1352, U.S. Code. Any person failing to file the required certification is subject to a civil penalty of not less than $10,000 and not more than $100,000 for each failure. The form requires completion with the date, solicitation number, vendor name, authorized signer name, and authorized signature.
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Other files
| File | Type | Posted |
|---|---|---|
| Cloud Checklist~2.xlsx | XLSX spreadsheet | |
| Quote Instructions (1).pdf | ||
| Quote Instructions (2).pdf | ||
| 40DHHS-S3547 - Clarification on Question 128.docx | DOCX document | |
| 40DHHS-S3547 - request-for-proposals - final~2.docx | DOCX document | |
| 55AGR-S3574 PIZZA -reference-questionnaire.docx | DOCX document | |
| 40DHHS-S3547 - Vendor-Information-Response.pdf | ||
| 55AGR-S3574 PIZZA -Vendor-Information-Response.pdf | ||
| 55AGR-S3574 PIZZA -Request for Samples.docx | DOCX document | |
| 55AGR-S3574- State Processing Agreement.doc | DOC document | |
| Insurance Schedule~7.docx | DOCX document | |
| 40DHHS-S3547 Questions and Answers - Final.docx | DOCX document | |
| 40DHHS-S3547 - reference-questionnaire .docx | DOCX document | |
| Quote Instructions (10).pdf | ||
| Cost Schedule~12.xlsx | XLSX spreadsheet | |
| 55AGR-S3574 Cost Schedule.xlsx | XLSX spreadsheet |
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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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