FNS 732 USDA Certification Regarding Lobbying Agreement.pdf

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Attached to
Preadmission Screening and Resident Reviews (PASRR) Level II Screens
Solicitation number
S-0627 DCTS-17
Issued by
Wisconsin

About this file

This is a USDA Certification Regarding Lobbying Agreement (Form FNS-732) issued by the U.S. Department of Agriculture in connection with a Wisconsin Department of Health Services contract opportunity for Preadmission Screening and Resident Reviews (PASRR) Level II Screens. The form establishes federal compliance requirements for vendors bidding on contracts to evaluate prospective and current nursing home residents in Wisconsin who have serious mental illness or intellectual/developmental disabilities. As a federal compliance document, the form does not specify project quantities, response dates, due dates, site visits, bidder meetings, award dates, or contract terms; rather, it serves as a prerequisite certification that must be completed and submitted by bidders prior to contract award for any federal action exceeding $100,000 (or $150,000 for loans).

The certification requires bidders and their sub-tier contractors to certify that no federal appropriated funds have been or will be paid to lobbyists for influencing federal agency officials, Members of Congress, or congressional employees in connection with the contract award. Any non-federal funds used for lobbying activities must be disclosed on Standard Form-LLL in accordance with Section 319 of Public Law 101-121 (31 U.S.C. Section 1352). Bidders must also ensure that all sub-awards include identical certification language and that all sub-recipients certify and disclose accordingly. Failure to submit the required certification subjects organizations to civil penalties ranging from $10,000 to $100,000 for each violation. This certification is a material representation of fact and a prerequisite for contract execution, with implementing regulations published in the February 26, 1990, Federal Register.

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Electronic Form Version Designed in Adobe 7.1 VersionFORM FNS-732 (12/01)

The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will 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 Federal appropriated funds have been paid or will 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, U.S. DEPARTMENT OF AGRICULTURE

CERTIFICATION REGARDING LOBBYING - CONTRACTS,

GRANTS LOANS AND COOPERATIVE AGREEMENTS

loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure form to Report Lobbying," 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, title 31, U.S. Code.

Any person who fails to file the required certification shall be subject to a civil penalty of not less that $10,000 and not more than $100,000 for each such failure.

Organization Name

Name(s) and Title(s) of Authorized Representative(s)

Signature(s)

PR/Award Number or Project Name

Date

SBU

FORM FNS-732 (12/01)

Section 319 of Public Law 101-121 (31 U.S.C.), signed into law on October 23, 1989, imposes new prohibitions and requirements for disclosure and certification related to lobbying on recipients of Federal contracts, grants, cooperative agreements, and loans. Certain provisions of the law also apply to Federal commitments for loan guarantees and insurance; however, it provided exemptions for Indian tribes and tribal organizations.

Effective December 23, 1989, current and prospective recipients (and their sub-tier contractors and/or sub-grantees) will be prohibited from using Federal funds,other than profits from a Federal contract, for lobbying Congress or any Federal agency in connection with the award of a particular contract, grant, cooperative agreement or loan. In addition, for each award action in excess of $100,000 (or $150,000 for loans) on or after December 23, 1989, the law requires recipients and their sub-tier contractors and/or sub-grantees to: (1) certify that they have neither used nor will use any appropriated funds for payment to lobbyists; (2) disclose the name, address, payment details, and purpose of any agreements with lobbyists whom recipients or their sub-tier contractors or sub-grantees will pay with profits or non-appropriated funds on or after December 23, 1989; and

(3) file quarterly updates about the use of lobbyists if materials changes occur in their use. The law establishes civil penalties for noncompliance.

If you are a current recipient of funding or have an application, proposal, or bid pending as of December 23, 1989, the law will have the following immediate consequences for you:

* You are prohibited from using appropriated funds (other than profits from Federal contracts) on or after December 23, 1989, for lobbying Congress or any Federal agency in connection with a particular contract, grant, cooperative agreement, or loan;

* you are required to execute the attached certification at the time of submission of an application or before any action in excess of $100,000 is awarded; and

* you will be required to complete the lobbying disclosure form if the disclosure requirements apply to you.

Regulations implementing Section 319 of Public Law 101-121 have been published as an Interim Final Rule by the Office of Management and Budget as Part III of the February 26, 1990, Federal Register (pages 6736-6746).

Electronic Form Version Designed in Adobe 7.1 Version

U.S. DEPARTMENT OF AGRICULTURE

NOTICE TO APPLICANTS - CERTIFICATION/DISCLOSURE

REQUIREMENTS RELATED TO LOBBYING

Electronic Form Version Designed in Adobe 7.1 Version

FORM FNS-732 (12/01)

The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will 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 Federal appropriated funds have been paid or will 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, U.S. DEPARTMENT OF AGRICULTURE

CERTIFICATION REGARDING LOBBYING - CONTRACTS,

GRANTS LOANS AND COOPERATIVE AGREEMENTS

loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure form to Report Lobbying," 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, title 31, U.S. Code.

Any person who fails to file the required certification shall be subject to a civil penalty of not less that $10,000 and not more than $100,000 for each such failure.

Organization Name Name(s) and Title(s) of Authorized Representative(s) Signature(s) PR/Award Number or Project Name Date

SBU

FORM FNS-732 (12/01)

Section 319 of Public Law 101-121 (31 U.S.C.), signed into law on October 23, 1989, imposes new prohibitions and requirements for disclosure and certification related to lobbying on recipients of Federal contracts, grants, cooperative agreements, and loans. Certain provisions of the law also apply to Federal commitments for loan guarantees and insurance; however, it provided exemptions for Indian tribes and tribal organizations.

Effective December 23, 1989, current and prospective recipients (and their sub-tier contractors and/or sub-grantees) will be prohibited from using Federal funds,other than profits from a Federal contract, for lobbying Congress or any Federal agency in connection with the award of a particular contract, grant, cooperative agreement or loan. In addition, for each award action in excess of $100,000 (or $150,000 for loans) on or after December 23, 1989, the law requires recipients and their sub-tier contractors and/or sub-grantees to: (1) certify that they have neither used nor will use any appropriated funds for payment to lobbyists; (2) disclose the name, address, payment details, and purpose of any agreements with lobbyists whom recipients or their sub-tier contractors or sub-grantees will pay with profits or non-appropriated funds on or after December 23, 1989; and (3) file quarterly updates about the use of lobbyists if materials changes occur in their use. The law establishes civil penalties for noncompliance.

If you are a current recipient of funding or have an application, proposal, or bid pending as of December 23, 1989, the law will have the following immediate consequences for you:

* You are prohibited from using appropriated funds (other than profits from Federal contracts) on or after December 23, 1989, for lobbying Congress or any Federal agency in connection with a particular contract, grant, cooperative agreement, or loan;

* you are required to execute the attached certification at the time of submission of an application or before any action in excess of $100,000 is awarded; and

* you will be required to complete the lobbying disclosure form if the disclosure requirements apply to you.

Regulations implementing Section 319 of Public Law 101-121 have been published as an Interim Final Rule by the Office of Management and Budget as Part III of the February 26, 1990, Federal Register (pages 6736-6746).

Electronic Form Version Designed in Adobe 7.1 Version

U.S. DEPARTMENT OF AGRICULTURE

NOTICE TO APPLICANTS - CERTIFICATION/DISCLOSURE

REQUIREMENTS RELATED TO LOBBYING

8.0.1291.1.339988.308172

ENTER ORGANIZATION NAME:
ENTER DATE:
ENTER AWARD NUMBER:
ENTER NAMES AND TITLES OF REPRESENTATIVES:
PRINT FORM:

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