Certification-regarding-lobbying~11.pdf
PDF 120 KB Posted
- Attached to
- Psychiatrist Services - NYTC
- Solicitation number
- 40DHHS-S3318
- Issued by
- Elko County, Nevada
About this file
This document is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, located in Carson City, Nevada. The form is a standardized federal certification that requires vendors to disclose and certify that they have not used federal appropriated funds to influence or attempt to influence government officials in connection with the awarding of federal contracts, grants, loans, or cooperative agreements.
The certification requires vendors to affirm three key points: first, that no federal funds have been used to influence government officials; second, that if non-federal funds were used for lobbying, the vendor must complete and submit a Standard Form-LLL "Disclosure of Lobbying Activities"; and third, that the vendor will require similar certification language in all sub-awards and lower-tier contracts. The document stipulates that failure to file the required certification can result in civil penalties ranging from $10,000 to $100,000 for each violation. The form provides blank spaces for a vendor to enter the date, solicitation number, vendor name, authorized signer name, and signature.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 40DHHS-S3318-RFP_Psychiatric Services.docx | DOCX document | |
| Vendor Information Response~1.pdf | ||
| 40DHHS-S3318-Business Associate Addendum.docx | DOCX document | |
| 40DHHS-S3318-Cost Schedule.docx | DOCX document | |
| 40DHHS-S3318-Fiscal Procedures.doc | DOC document | |
| Standard-form-contract~11.docx | DOCX document | |
| Terms-and-conditions-for-services~12.pdf | ||
| 40DHHS-S3318 Insurance Schedule.pdf | ||
| Quote Instructions.pdf | ||
| 40DHHS-S3318-Reference-Questionnaire.pdf |
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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: |
File details come from the government source that posted it. Updated .