7-Form - Lobbying.pdf
PDF 68 KB Posted
- Attached to
- Annual Bid to Furnish and Deliver Polymer
- Solicitation number
- 2027002
- Issued by
- Indian River County, Florida
About this file
This file is a Certification Regarding Lobbying form required for the Florida state and local contract opportunity for the annual bid to furnish and deliver polymer. The form must be submitted with the bid and certifies that no federal appropriated funds have been or will be paid to influence federal officials, members of Congress, or congressional employees in connection with the contract award. The contract opportunity involves establishing firm fixed prices for polymer delivery on an as-needed basis for the period October 1, 2026, through September 30, 2027.
The certification form requires the contractor's authorized official to sign and affirm the truthfulness and accuracy of the statements. If any non-federal funds have been or will be paid for lobbying purposes, the contractor must complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying." The form also mandates that contractors include identical certification language in all subaward documents and require all subrecipients to certify and disclose accordingly. Contractors who fail to file the required certification are subject to civil penalties ranging from $10,000 to $100,000 for each failure, and the provisions of 31 U.S.C. §3801 et seq. apply to the certification and disclosure requirements.
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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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