Certification-regarding-lobbying~3.pdf
PDF 120 KB Posted
- Solicitation number
- 40DHHS-S3626
- 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 federal contract procurement activities. The form establishes compliance requirements for contractors and subcontractors engaging in state and local contract opportunities that involve federal funding. The document requires the undersigned to certify that no federal appropriated funds have been or will be paid to influence officers or employees of any agency, members of Congress, or congressional staff in connection with the awarding of federal contracts, grants, loans, or cooperative agreements. Additionally, the form stipulates that contractors must include identical certification language in all subaward documents at every tier, including subcontracts and subgrants, and ensure that all subrecipients certify and disclose accordingly.
The certification represents a material representation of fact required under section 1352, U.S. Code, and submission is a mandatory prerequisite for entering into the transaction. Failure to file the required certification subjects the responsible party to civil penalties ranging from not less than $10,000 to not more than $100,000 for each failure. The form requires completion of Standard Form-LLL, "Disclosure of Lobbying Activities," if any non-federal funds have been or will be paid for lobbying purposes in connection with the federal contract, grant, loan, or cooperative agreement. Signature blocks are provided for the authorized signer, vendor name, solicitation number, and date to complete the certification submission.
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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/
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