Certification-regarding-lobbying~5.pdf
PDF 120 KB Posted
- Attached to
- Rehabilitation of Fire Investigation Burn Cells
- Solicitation number
- 65DPS-S3656
- 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 standard federal compliance certification required for state and local contract opportunities that involve federal appropriated funds. The form requires the undersigned vendor or contractor to certify that no federal appropriated funds have been or will be used to influence officers or employees of any federal agency, members of Congress, or congressional staff in connection with the awarding of federal contracts, grants, loans, cooperative agreements, or related modifications. The certification must be completed and signed by an authorized representative of the vendor, with the solicitation number and vendor name clearly identified on the form.
The document further requires that if any non-federal funds have been or will be paid for lobbying activities related to the federal transaction, the vendor must complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. Additionally, vendors are required to include the language of this certification in all sub-award documents at all tiers, including subcontracts and sub-grants, with all sub-recipients certifying and disclosing accordingly. The certification constitutes a material representation of fact, and submission is a prerequisite for transaction execution. Failure to file the required certification subjects the non-compliant party to civil penalties ranging from $10,000 to $100,000 for each failure, as established under section 1352, U.S. Code.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Standard-form-contract~4.docx | DOCX document | |
| Attachment BB-1 Stand-alone Units.pdf | ||
| 65DPS-S3656-Reference-Questionnaire.docx | DOCX document | |
| Attachment CC SFMD Materials List.pdf | ||
| Quote Instructions.pdf | ||
| 65DPS-S3658 - Notice of Intent.pdf | ||
| Attachment DD-1 Damage Report.pdf | ||
| 65DPS-S3656 - Cost Proposal.docx | DOCX document | |
| 65DPS-S3656 - Insurance Schedule - RFP.docx | DOCX document | |
| 65DPS-S3656 - Request-for-Proposals.docx | DOCX document | |
| Attachment BB Trailer photos.pdf | ||
| Attachment DD Damage Report.pdf | ||
| Terms-and-conditions-for-services~5.pdf | ||
| 65DPS-S3656-Vendor-Information-Response.pdf |
Show all 14
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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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