Amended Attachment J.5 - SF-LLL Form.pdf
PDF 33 KB Posted
- Attached to
- 7200AA21R00041 Water and Development (WADI) II Indefinite Delivery and Indefinite Quantity RFP
- Solicitation number
- 7200AA21R00041
About this file
This document contains an amended SF-LLL disclosure of lobbying form and details of a related federal contract opportunity solicitation. The solicitation is for multiple award IDIQ contracts to provide innovative water and development services in support of USAID's Center for Water Security, Sanitation and Hygiene. USAID anticipates awarding approximately eight IDIQ contracts, of which up to three may be reserved for small businesses. Services required include support for USAID's WADI II program. The period of performance is not specified. Responses were due as detailed in solicitation number 7200AA21R00041. The federal agency involved is USAID within the Bureau for Management.
View the file
Other files
Show all 17
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
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
File details come from the government source that posted it. Updated .