J-39_-_Disclosure_of_Lobbying_Activities.pdf
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This disclosure of lobbying activities form details reporting requirements for recipients of federal funds. Any entity that expends $250,000 or more for lobbying activities in a semi-annual period must report names, addresses, and payment amounts for any registrants or individuals performing lobbying activities. Reporting is required regardless of the success of lobbying and intended to provide transparency to Congress and the public. Failure to report can incur civil penalties of $10,000 to $100,000 per missed disclosure.
This solicitation seeks a contractor to provide infrastructure and standard operations support for the Department of Transportation's Common Operating Environment. The NAICS code is 541513 with a $27.5 million size standard. Unrestricted and small business set-aside proposals are due in person on January 8, 2019 between 10:00 am and 3:00 pm Eastern at DOT headquarters. Offerors must submit twenty thumb drives each with their technical and business volumes in a sealed envelope listing company name and point of contact. The Department of Transportation's Immediate Office of the Secretary is the contracting agency.
J-39 - Disclosure of Lobbying Activities
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10. a. Name and Address of Lobbying Registrant:
9. Award Amount, if known:
* Street 1
* City State Zip
Street 2
* Last Name
Prefix * First Name Middle Name
Suffix
DISCLOSURE OF LOBBYING ACTIVITIES
Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352
Approved by OMB
0348-0046
1. * Type of Federal Action:
a. contract
b. grant
c. cooperative agreement
d. loan
e. loan guarantee
f. loan insurance
2. * Status of Federal Action:
a. bid/offer/application
b. initial award
c. post-award
3. * Report Type:
a. initial filing
b. material change
4. Name and Address of Reporting Entity:
Prime SubAwardee
* Name
* Street 1 Street 2
* City State Zip
Congressional District, if known:
6. * Federal Department/Agency: 7. * Federal Program Name/Description:
CFDA Number, if applicable:
8. Federal Action Number, if known:
b. Individual Performing Services (including address if different from No. 10a)
Prefix * First Name Middle Name
* Street 1
* City State Zip
Street 2
Suffix* Last Name
11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
* Signature:
*Name: Prefix * First Name Middle Name
* Last Name Suffix
Title: Telephone No.: Date:
Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97)
5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime:
Completed on submission to Grants.gov
Completed on submission to Grants.gov
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