__ExhibitD- Disclosure of Lobbying Activities.pdf
PDF 160 KB Posted
- Attached to
- Safety Service Patrol-York County
- Solicitation number
- 6100065384
- Issued by
- York County, Pennsylvania
About this file
This is a Disclosure of Lobbying Activities form (Standard Form LLL) required pursuant to 31 U.S.C. Section 1352 for the Safety Service Patrol-York County contract opportunity in Pennsylvania. The form is used to document lobbying activities related to federal actions, including contracts, grants, cooperative agreements, loans, loan guarantees, and loan insurance. The disclosure applies to the York County Safety Service Patrol contract, which aims to provide expeditious removal of disabled or accident vehicles and small non-hazardous debris from roadways to reduce traffic delays and congestion in York County, Pennsylvania.
The form requires reporting entities to disclose information about lobbying registrants and individuals performing lobbying services on behalf of the bidding organization. Entities must indicate the status of the federal action (bid/offer/application, initial award, or post-award), the report type (initial filing or material change), and provide details about the reporting entity, prime contractor or subawardee status, federal department or agency involved, federal program name, award amount, and lobbying registrant information. Failure to file the required disclosure subjects organizations to civil penalties ranging from $10,000 to $100,000 for each violation. The form will be reported to Congress semi-annually and made available for public inspection, serving as a material representation of fact upon which the federal government relies when awarding contracts.
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Text version
DISCLOSURE OF LOBBYING ACTIVITIES
Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 OMB Number: 4040-0013
Expiration Date: 02/28/2025
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
4. Name and Address of Reporting Entity:
Prime SubAwardee
* Name
* Street 1 Street 2
* City State
Congressional District, if known:
Zip
5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime:
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:
Prefix * First Name Middle Name
* Last Name Suffix
* Street 1 Street 2
* City State Zip
b. Individual Performing Services (including address if different from No. 10a)
Prefix * First Name Middle Name
* Last Name Suffix
* Street 1 Street 2
* City State Zip
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 the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and 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:
*Name: Prefix * First Name Middle Name
* Last Name Suffix
Title: Telephone No.: Date:
Federal Use Only: Authorized for Local Reproduction Standard Form - LLL (Rev. 7-97)
Review Public Burden Disclosure Statement
| a contract: Off |
| b grant: Off |
| a initial filing: Off |
| b material change: Off |
| c cooperative agreement: |
| undefined: Off |
| undefined_2: Off |
| undefined_3: Off |
| d loan: |
| e loan guarantee: Off |
| f loan insurance: Off |
| Prime: Off |
| SubAwardee: Off |
| Name: |
| Street 1: |
| Street 2: |
| City: |
| State: |
| Zip: |
| Congressional District if known: |
| 5 If Reporting Entity in No4 is Subawardee Enter Name and Address of Prime: |
| undefined_4: |
| 10 a Name and Address of Lobbying Registrant: |
| undefined_5: |
| Prefix: |
| First Name: |
| Middle Name: |
| Last Name: |
| Suffix: |
| Street 1_2: |
| Street 2_2: |
| City_2: |
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| Zip_2: |
| Prefix_2: |
| First Name_2: |
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| Last Name_2: |
| Suffix_2: |
| Street 1_3: |
| Street 2_3: |
| City_3: |
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| Zip_3: |
| Prefix_3: |
| First Name_3: |
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| Title: |
| Telephone No: |
| Date: |
| Authorized for Local Reproduction Standard Form LLL Rev 797: |
| View Burden Statement: |
| 7: |
| Federal Program Name/Description: |
CFDA Number if applicable:
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