Certification-regarding-lobbying~5.pdf
PDF 120 KB Posted
- Attached to
- Rehabilitation of Fire Investigation Burn Cells
- Solicitation number
- 65DPS-S3798
- 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 form serves as a prerequisite certification for vendors participating in Federal contract opportunities administered through the State of Nevada. The certification requires the undersigned vendor to attest that no Federal appropriated funds have been paid or will be paid to influence Federal decision-makers in connection with the awarding of Federal contracts, grants, loans, or cooperative agreements. Vendors must provide their name, solicitation number, authorized signer information, and date of execution on the form.
If any non-Federal funds have been or will be paid for lobbying activities related to the Federal transaction, the vendor is required to complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. The certification language must be included in all award documents for subcontractors and sub-recipients at all tiers. Failure to file the required certification subjects the vendor to civil penalties ranging from $10,000 to $100,000 for each violation. This certification is a material representation of fact required by Section 1352 of the U.S. Code and constitutes a condition precedent to entering into the Federal transaction.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment DD-1 Damage Report.pdf | ||
| Attachment CC SFMD Materials List.pdf | ||
| Terms-and-conditions-for-services~5.pdf | ||
| 65DPS-S3798 - Insurance Schedule - RFP.docx | DOCX document | |
| 65DPS-S3798-Vendor-Information-Response.pdf | ||
| Standard-form-contract~4.docx | DOCX document | |
| 65DPS-S3798 - Cost Proposal.docx | DOCX document | |
| Attachment BB Trailer photos.pdf | ||
| Attachment DD Damage Report.pdf | ||
| Quote Instructions.pdf | ||
| 65DPS-S3798-Reference-Questionnaire.docx | DOCX document | |
| Attachment BB-1 Stand-alone Units.pdf | ||
| 65DPS-S3798 - Request-for-Proposals.docx | DOCX document |
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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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