J.3 Disclosure of Lobbying Activities - Standard Form LLL (SF LLL).pdf
Standard Form PDF 158 KB Posted
- Solicitation number
- 693JJ923R0000134
About this file
This document is a Standard Form LLL disclosure of lobbying activities template. It collects information on the type of federal action, status of action, report type, names and addresses of reporting entities and lobbyists, federal department or agency involved, and federal program name or description. The related federal contract opportunity is solicitation number 693JJ923R0000134 from the Department of Transportation National Highway Traffic Safety Administration for a demonstration project to address special needs and student behavior on school buses. Details collected on the lobbying activities disclosure form will be reported to Congress semi-annually and made available for public inspection.
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Other versions and copies of SF LLL
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Who attaches SF LLL
| State | Files |
|---|---|
| Florida | 37 |
| Montana | 16 |
| California | 8 |
| Colorado | 7 |
| Virginia | 6 |
Other files
| File | Type | Posted |
|---|---|---|
| RFP 693JJ923R000134 Q and A.pdf | ||
| RFP 693JJ923R000134 Q and A Addendum Section C.6.5_.pdf | ||
| J.4 Travel Cost Breakdown Spreadsheet.xlsx | XLSX spreadsheet | |
| J 1 (Past Performance Questionnaire).pdf | ||
| RFP 693JJ923R000134 NHTSA _7.25.2023pdf.pdf | ||
| J.2 Cost Proposal Template (CPFF).xlsx | XLSX spreadsheet | |
| J.5 Other Direct Cost Breakdown Spreadsheet.xlsx | XLSX spreadsheet | |
| J.6 Subcontracting Checklist.docx | DOCX document | |
| J.7 Small Business Subcontracting Plan Template.docx | DOCX document |
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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 |
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| e loan guarantee: Off |
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| Authorized for Local Reproduction Standard Form LLL Rev 797: |
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| Federal Program Name/Description: |
CFDA Number if applicable:
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