Certification-regarding-lobbying~4.pdf
PDF 120 KB Posted
- Attached to
- Culvert Pipe
- Solicitation number
- 80DOT-S3642
- 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. The document serves as a mandatory certification requirement for vendors and contractors engaging in federal contracts, grants, loans, or cooperative agreements administered through the State of Nevada. The certification confirms that no federally appropriated funds have been or will be used to influence federal officers, members of Congress, or congressional employees in connection with the awarding of federal contracts, grants, loans, or cooperative agreements, or modifications thereof. Vendors must complete this form and provide authorization signatures along with the solicitation number and submission date.
The document establishes compliance obligations requiring vendors to disclose any non-federally appropriated funds used for lobbying activities by submitting Standard Form-LLL, "Disclosure of Lobbying Activities." Vendors are required to cascade this certification language and requirements to all sub-tier recipients, including subcontractors and sub-grantees. Failure to submit the required certification subjects responsible parties to civil penalties ranging from $10,000 to $100,000 per violation. The certification is designated as a material representation of fact upon which transaction approval is contingent, as mandated by Section 1352 of the U.S. Code.
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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/
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