Attachment_4_-_Disclosure_of_Lobbying_Activities.pdf
PDF 1 MB Posted
- Attached to
- NIH Fleet Management and Maintenance
- Solicitation number
- 75N98024R00019
About this file
The document provided is the Disclosure of Lobbying Activities form (Standard Form LLL), which is required to be submitted with federal contract proposals to disclose any lobbying activities. The form requires the reporting entity to provide information such as the type of federal action, the status and report type, the name and address of the reporting entity, the federal department/agency, the federal action number, and the name and address of any lobbyists or individuals performing lobbying services. This form is a material representation of fact that is relied upon by the government and must be completed accurately, with failure to file resulting in civil penalties.
The related federal contract opportunity is for Maintenance, Repairs and Towing services for Government Owned Vehicles, solicited by the Department of Health and Human Services National Institutes of Health Office of Logistics and Acquisition Operations under Solicitation Number 75N98024R00019. The contract is for fleet management and maintenance services.
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DISCLOSURE OF LOBBYING ACTIVITIES
Attachment 4
Approved by 0MB
0348-0046 Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure.)
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
n a. contract
b. grant na, bid/offer/application
b. initial award n a. initial filing
b. material change
c. cooperative agreement c. post-award For Material Change Only:
d. loan
e. loan guarantee
f. loan insurance
4. Name and Address of Reporting Entity:
D Prime D Subawardee
Tier if known:
Congressional District, if known: 4c
6. Federal Department/Agency:
8. Federal Action Number, if known:
10. a. Name and Address of Lobbying Registrant ( if individual, last name, first name, M/):
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 this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information 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.
Federal Use Only:
year quarter date of last report
5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime:
Congressional District, if known:
7. Federal Program Name/Description:
CFDA Number, if applicable:
9. Award Amount, if known:
b. Individuals Performing Services (including address if different from No. 1 Oa)
(last name, first name, Ml):
Signature:
Print Name:
Title:
Telephone No.: Date:
I Authorized for Local Reproduction
Standard Form LLL (Rev. 7-97)
File details come from the government source that posted it. Updated .