Certification-regarding-lobbying~29.pdf
PDF 120 KB Posted
- Attached to
- APS Forensic Medical
- Solicitation number
- 40DHHS-S4057
- Issued by
- Churchill County, Nevada
About this file
This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, in conjunction with an Aging and Disability Services Division solicitation for forensic medical services. The document establishes compliance requirements for federal funding associated with this state contract opportunity. The Aging and Disability Services Division is seeking qualified vendors to provide forensic services as described in the associated scope of work, with the State intending to award one contract based on what it determines to be in its best interests. The resulting contract is expected to have a term of four years.
The certification form requires the undersigned vendor to confirm that no federally appropriated funds have been or will be paid to influence any officer or employee of a federal agency, Member of Congress, or congressional employee in connection with the awarding of this federal contract or any related federal 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 subcontractors must include similar certification language in their award documents and certify and disclose accordingly. Failure to file the required certification subjects vendors to civil penalties ranging from $10,000 to $100,000 for each failure. The form requires completion of fields for date, solicitation number, vendor name, authorized signer name, and authorized signature.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| APS Forensic Medical Specialist Epro Solicitation 2026~1.pdf | ||
| Terms-and-conditions-for-services~35.pdf | ||
| Attachment A - Contract Template.pdf | ||
| 08DOA-S4023 - Vendor-Information-Response.pdf | ||
| cost-schedule.xlsx | XLSX spreadsheet | |
| Attachment B - Insurance Requirements.pdf | ||
| Quote Instructions.pdf | ||
| BAA 2024 (2) (3).docx | DOCX document |
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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 .