Certifcation_Lobbying_Child___Family_Resources.pdf

PDF 231 KB Posted

Attached to
Master Agreement AZ|CTR072042
Contract number
CTR072042
Issued by
Arizona

About this file

This document is a Certification Regarding Lobbying form for a solicitation (No. BPM005727) related to Child Care Resource & Referral Services, issued by the Arizona Department of Economic Security. The form is completed by Child & Family Resources, Inc., with Eric Edward Schindler, Ph.D. as the President/CEO, serving as the authorized representative.

The document is a standard federal certification that prohibits the use of federal appropriated funds to influence or attempt to influence government officials or members of Congress in connection with federal contracts, grants, loans, or cooperative agreements. It requires the undersigned to disclose any non-federal funds used for lobbying activities and mandates that this certification language be included in all subawards and subcontracts. The form emphasizes that failure to file the required certification can result in civil penalties ranging from $10,000 to $100,000 for each violation, underscoring the serious nature of lobbying disclosure requirements.

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Text version

Offeror Submittal Documents

Solicitation No.: BPM005727

Description: Child Care Resource & Referral Services

RFP Solicitation Instructions (06-23) Available Online at https://app.az.gov Page 21 of 34

Attachment 4 - Certification Regarding Lobbying

Certification for Contracts, Grants, Loans, and Cooperative Agreements

The undersigned certifies, to the best of his or her knowledge and belief, 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 of Lobbying Activities,'' 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 section 1352, title 31, U.S. Code. 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.

Statement for Loan Guarantees and Loan Insurance

The undersigned states, to the best of his or her knowledge and belief, that:

If any 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 commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, ''Disclosure of Lobbying Activities,'' in accordance with its instructions.

Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

APPLICANT’S ORGANIZATION

*PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

Prefix:

*First Name: *Middle Name: *Last

Name: *Suffix:

*Title:

*SIGNATURE *DATE

https://app.az.gov/ sfauland@cfraz.org Typewriter Child & Family Resources, Inc.

sfauland@cfraz.org Typewriter Eric sfauland@cfraz.org Typewriter Schindler sfauland@cfraz.org Typewriter Ph.D.

sfauland@cfraz.org Typewriter President/CEO sfauland@cfraz.org Typewriter 11/6/2023 sfauland@cfraz.org Typewriter Edward

Uniform Instructions to Offerors
Attachment 4 - Certification Regarding Lobbying

File details come from the government source that posted it. Updated .