Attachment_J_Byrd_Anti-Lobbying_Form.pdf
PDF 86 KB Posted
- Attached to
- Body Shop Repairs
- Solicitation number
- ITB 0029-24
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
The document is a Byrd Anti-Lobbying Form for the City of Fort Myers, Florida, related to a Fleet Auto Body Repair contract opportunity. This standardized federal certification form is required for submissions exceeding $100,000 and ensures that no federal appropriated funds will be used to influence or attempt to influence government officials in connection with the awarding of federal contracts, grants, loans, or cooperative contracts.
The form requires the company to certify that it has not and will not pay any person to influence government officials in the contract process. If any non-federal funds are used for such purposes, the company must complete a Standard Form - LLL "Disclosure Form to Report Lobbying." Failure to file the required certification can result in civil penalties ranging from $10,000 to $100,000 for each violation. The form must be signed by an authorized company official and includes provisions that the certification language must be included in all subawards and subcontracts at all tiers.
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Text version
ATTACHMENT J
BYRD ANTI-LOBBYING FORM
To be submitted with each submission exceeding $100,000.00.
The undersigned, ___________________________________________________of _____________________________
(the “company”) hereby certifies, to the best of his or her knowledge, that:
1. No Federal appropriated funds have paid or will be paid, by or on behalf of 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 Contract, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative Contract.
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 Contract, 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 Contracts) 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 (as amended by the Lobbying Disclosure Act of 1995). 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 Company 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 Company Authorized Official
Name and Title of Company Authorized Official Date
File details come from the government source that posted it. Updated .