Certification-regarding-lobbying~7.pdf
PDF 120 KB Posted
- Attached to
- Nevada Average Acquisition Cost
- Solicitation number
- 41NHA-S3922
- Issued by
- Nevada
About this file
This is a Certification Regarding Lobbying form issued by the Nevada State Purchasing Division, Department of Administration, applicable to a Nevada Health Authority procurement for Nevada Average Acquisition Cost. The form serves as a compliance document for vendors participating in state and local contracting opportunities managed through Nevada's purchasing division and the nevadaepro.com procurement portal. The document does not specify particular products, services, quantities, response dates, or contract terms, as it functions as a standardized certification requirement rather than a detailed scope of work or project description.
The certification requires vendors and their authorized signers to affirm that no federal appropriated funds have been or will be used to influence government officials in connection with the contract award, and that any non-federal funds used for lobbying activities must be disclosed on Standard Form-LLL. Vendors must ensure identical certification language is included in all subcontract and sub-award documents at all tiers. The form constitutes a material representation of fact required by section 1352 of the U.S. Code, with violations subject to civil penalties ranging from $10,000 to $100,000 per failure. The document requires completion with the solicitation number, vendor name, authorized signer information, and date prior to submission.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 41NHA-S3922 - Cost Schedule.xlsx | XLSX spreadsheet | |
| 41NHA-S3922 - RFP Technical Proposal Questions.docx | DOCX document | |
| 41NHA-S3922 - Insurance Schedule - RFP.docx | DOCX document | |
| 41NHA-S3922 - Scope of Work and Deliverables.docx | DOCX document | |
| Terms-and-conditions-for-services~7.pdf | ||
| 41NHA-S3922 - Business Associate Addendum.docx | DOCX document | |
| 41NHA-S3922-Reference-Questionnaire.docx | DOCX document | |
| 41NHA-S3922 - Request-for-Proposals.docx | DOCX document | |
| 41NHA-S3922-Vendor-Information-Response.pdf | ||
| Standard-form-contract~5.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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