Certification-regarding-lobbying~10.pdf
PDF 120 KB Posted
- Solicitation number
- 41NHA-S4038
- Issued by
- Nevada
About this file
This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division under the Department of Administration. The document serves as a mandatory certification requirement for vendors bidding on federal contracts, grants, loans, or cooperative agreements administered through the State of Nevada.
The certification requires the authorized representative of the vendor to attest that no federal appropriated funds have been or will be used to influence federal officers, members of Congress, or their employees in connection with the award of federal contracts, grants, loans, or cooperative agreements. If non-federal funds have been or will be used for lobbying activities related to the federal contract, the vendor must complete and submit Standard Form-LLL, Disclosure of Lobbying Activities. The form mandates that vendors include identical certification language in all sub-award documents at all tiers, including subcontracts and sub-grants, and require all sub-recipients to certify and disclose accordingly. Failure to file the required certification subjects the vendor to civil penalties ranging from $10,000 to $100,000 for each failure. The document includes blank fields for the solicitation number, vendor name, authorized signer name and signature, and date of submission.
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Other files
| File | Type | Posted |
|---|---|---|
| 41NHA-S4038-Reference-Questionnaire.docx | DOCX document | |
| Standard-form-contract~9.docx | DOCX document | |
| 41NHA-S4038 - Business Continuity Agreement 12.01.25.docx | DOCX document | |
| 41NHA-S4038 - Business Associate Addendum 07.01.25.docx | DOCX document | |
| 41NHA-S4038 - SOW - 10-08.docx | DOCX document | |
| 41NHA-S4038-Vendor-Information-Response.pdf | ||
| 41NHA-S4038 - Insurance Schedule - RFP.docx | DOCX document | |
| Terms-and-conditions-for-services~11.pdf | ||
| 41NHA-S4038 - Attachment B - PACE Service Delivery Arrangements.docx | DOCX document | |
| 41NHA-S4038-Request-for-Proposals.docx | DOCX document | |
| 41NHA-S4038 - Attachment A- PACE Technical Proposal Questions.docx | DOCX document |
Show all 11
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Text version
Nevada State Purchasing Division Department of Administration 515 E Musser St Ste 300 Carson City, NV 89701 purchasing.nv.gov nevadaepro.com
Revised 2024-10 Page 1 of 1
Certification regarding lobbying
The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or shall be paid, by or on behalf of the undersigned, 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 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 Federally appropriated funds have been paid or shall 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 sub awards at all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative agreements) and that all sub recipients 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, 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.
Date
Solicitation number
Vendor Name
Authorized signer name
Authorized signature https://purchasing.nv.gov/ https://nevadaepro.com/
| Date: |
| Solicitation number: |
| Vendor name: |
| Authorized signer name: |
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