Certification for Contracts page 16.pdf
PDF 78 KB Posted
- Attached to
- City Hall Courtyard Improvements
- Solicitation number
- 146070
- Issued by
- Ventura County, California
About this file
This is a Certification for Contracts, Grants, and Cooperative Agreements form required for Project No. CH-5177, applicable to the City Hall Courtyard Improvements project in California. The certification document serves as a mandatory attestation by a grantee official confirming compliance with federal lobbying restrictions and regulations governing the use of federal appropriated funds in connection with federal contracts, grants, loans, and cooperative agreements.
The certification requires the authorized grantee official to declare under penalty of law that no federal appropriated funds have been or will be used to influence federal agency officers, members of Congress, or congressional staff regarding the awarding or modification of federal contracts, grants, loans, or cooperative agreements. If non-federal funds have been or will be used for lobbying purposes, the grantee must complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with applicable instructions. Submission of this certification is a prerequisite for entering into the transaction, and failure to file the required certification subjects the responsible person to civil penalties ranging from $10,000 to $100,000 for each violation. The project involves insurance requirements of $2M/$4M as specified in the bid package.
View the file
Other files
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
Project No. CH-5177
CH-5177 BID PROPOSAL
- 16 -
CERTIFICATION FOR CONTRACTS,
GRANTS, AND COOPERATIVE AGREEMENTS
(Federal Fiscal Year October 1, 20____, to September 30, 20____)
I, , (Name and Title of Grantee Official) hereby certify on behalf of that (Name of Grantee)
(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 any Federal 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 Federal agency, a Member of Congress, an office 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 must complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
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 will be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Executed this __________ day of __________________, 20____.
By:
(Signature of Authorized Official)
(Title of Authorized Official)
File details come from the government source that posted it. Updated .