Certification-regarding-lobbying~5.pdf

PDF 120 KB Posted

Attached to
AASF Exterior Paint
Solicitation number
43ADG-S4009
Issued by
Nevada

About this file

This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division under the Department of Administration. The certification applies to the Army Aviation Support Facility (AASF) Exterior Paint contract opportunity with the Nevada National Guard. The form requires the undersigned vendor to certify that no federal appropriated funds have been paid or will be paid to influence officers or employees of any agency, Members of Congress, or congressional staff in connection with the awarding of this federal contract or related federal funding agreements.

The certification constitutes a material representation of fact and is a prerequisite for contract award as mandated by section 1352, U.S. Code. Vendors must complete the certification with their solicitation number, vendor name, authorized signer name, and date. If any non-federal funds have been or will be paid for lobbying activities, the vendor must submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. All sub-recipients and subcontractors are required to include identical certification language in their award documents and certify and disclose accordingly. Failure to file the required certification subjects a person to civil penalties ranging from $10,000 to $100,000 for each failure.

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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/

Date:
Solicitation number:
Vendor name:
Authorized signer name:

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