Certification-regarding-lobbying~5.pdf
PDF 120 KB Posted
- Attached to
- Travel Nevada - Agency of Record
- Solicitation number
- 10TCA-S3661
- 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 state and federal contract opportunities. The form serves as a mandatory certification that must be completed and submitted by vendors and contractors prior to award of any contract involving federal appropriated funds. The document requires the authorized representative of the bidding entity to certify compliance with federal lobbying restrictions and to acknowledge their understanding of disclosure requirements should non-federal funds be used for lobbying activities in connection with the contract award.
The certification constitutes a material representation of fact and is a prerequisite for contract execution under section 1352, U.S. Code. All vendors submitting bids on contracts involving federal funds must complete this form with their solicitation number, vendor name, authorized signer name, and signature. Vendors must also ensure that identical certification language and requirements are included in all subcontract award documents at all tiers. Failure to submit the required certification exposes the vendor to civil penalties ranging from $10,000 to $100,000 for each violation. The form was revised in October 2024 and is available through the Nevada e-Procurement system and the State Purchasing Division website.
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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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