Disclosure_of_Lobbying_Activities.pdf
PDF 153 KB Posted
- Attached to
- Bus Shelters and Amenities
- Solicitation number
- RTSX-260026-DS
- Issued by
- Alachua County, Glencoe CDP, Florida
About this file
This is a Standard Form LLL (SF-LLL), Disclosure of Lobbying Activities form, a federal compliance document required under 31 U.S.C. 1352 for entities engaging in lobbying activities related to covered federal actions. The form applies to the City of Gainesville's Regional Transit System (RTS) Bus Shelters and Amenities project in Florida, which seeks bid responses for various amenities to be installed at bus stops to enhance safety, accessibility, and comfort. The SF-LLL form must be completed and submitted by any reporting entity—whether a prime recipient or subawardee—upon initiation of a covered federal action or when a material change occurs to previously filed information. Completion of all applicable items is required for both initial filings and material change reports, with the form serving as a material representation of fact regarding any payments made to lobbying entities for influencing federal officers, members of Congress, or other specified federal personnel in connection with the project.
The disclosure form carries significant compliance requirements and penalties for non-compliance. Any person or entity failing to file the required disclosure is subject to a civil penalty of not less than $10,000 and not more than $100,000 for each failure. The form requires identification of the lobbying registrant engaged by the reporting entity, the individuals performing lobbying services, the federal agency making the award, the federal program name and CFDA number if applicable, and the federal action number and award amount if known. The filing must be signed by an authorized certifying official with their printed name, title, telephone number, and date of submission. This form is mandatory for federal funding-related state and local contract opportunities and serves as public disclosure information available for inspection.
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If this form is not applicable, mark “N/A”, sign and return.
DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046
(See next page for public burden disclosure.)
1. Type of Federal Action:
a. contract
b. grant
c. cooperative agreement
d. loan
e. loan guarantee
f. loan insurance
2. Status of Federal Action:
a. bid/offer/application
b. initial award
c. post-award
3. Report Type:
a. initial filing
b. material change
For Material Change Only:
year quarter date of last report
4. Name and Address of Reporting Entity:
Prime Subawardee
Tier , if known :
Congressional District, if known: 4c
5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime:
Congressional District, if known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number, if applicable:
8. Federal Action Number, if known : 9. Award Amount, if known :
10. a. Name and Address of Lobbying Registrant (if individual, last name, first name, MI):
b. Individuals Performing Services (including address if different from No. 10a )
(last name, first name, MI):
11. Information requested through this form is authorized by title 31 U.S.C.
section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Signature:
Print Name:
Title:
Telephone No.: Date:
Federal Use Only: Authorized for Local Reproduction Standard Form LLL (Rev. 7-97)
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity 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 a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient.
Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of
Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., “RFP-
DE-90-001.”
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of
1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).
11. The certifying official shall sign and date the form; print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503.
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