Certification-regarding-lobbying~14.pdf
PDF 120 KB Posted
- Attached to
- Clean Water Technical Assistance
- Solicitation number
- 70CNR-S4083
- Issued by
- Nevada
About this file
This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, for use in connection with the Clean Water Technical Assistance Request for Qualification (RFQ) issued by the Nevada Division of Environmental Protection. The form serves as a mandatory certification that no Federal appropriated funds have been or will be paid to influence officers or employees of any Federal agency, Members of Congress, or Congressional staff in connection with the award of Federal contracts, grants, loans, or cooperative agreements. Bidders and vendors are required to complete this certification form, providing the solicitation number, vendor name, authorized signer name and signature, and date before submission.
The certification establishes material representations of fact required under Section 1352 of U.S. Code and represents a prerequisite for entering into the transaction. Vendors must disclose any non-Federal funds used for lobbying activities by submitting Standard Form-LLL in accordance with its instructions. All sub-recipients and sub-awardees at all tiers are similarly bound by this certification requirement and must include the certification language in their award documents. Failure to file the required certification subjects individuals to civil penalties ranging from $10,000 to $100,000 for each violation. This form applies to Federal funding components associated with the Nevada clean water technical assistance project.
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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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