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25I - AGMT STAFFING SERVICES
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25I - AGMT STAFFING SERVICES
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Last modified
5/31/2018 8:00:10 PM
Creation date
5/31/2018 7:48:36 PM
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Personnel Services
Item #
25I
Date
6/5/2018
Destruction Year
2023
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NON-LORRYING CERTIFICATION <br />The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or <br />her knowledge and belief._ that: <br />(1) No Federal appropriated finds have been paid or will be paid, by or on behalf of the undersigned, <br />to any person for influencing or attempting to influence an officer or employee of any Federal <br />agency. a Member of Congress, an officer or employee of Congress, or an employee of a Member <br />of Congress in connection with the awarding of any Federal contract, the making of any Federal <br />grant, the ntnking of any Federal loan, the entering, into. of any cooperative agreement, and the <br />extension, continuation, renewal, amendment, or modification of any Federal contract,. grant, <br />loan, or cooperative agreement. <br />(2) Ifany funds other than Federal appropriated funds have been paid or Will be paid to any person <br />for influencing or attempting to influence an officer or employee of any Federal agency. a <br />Member of Congress, an officer or employee of Congress, or an employee of'a Member of <br />Congress in connection with this Federal contract, grant, loan, or cooperative agreement. the <br />undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities." <br />in conformance with its instructions. <br />This certification is a material representation of fact upon which reliance was placed when this transaction <br />Was made or entered into. Submission of this certification is a prerequisite for making or entering into this <br />transaction imposed by Section 1352, Title 3 L U.S. Code. Any person who fails to file the required <br />certification shall be subject to a civil penalty of not less than S10,000 and not more than 5100.000 for <br />each such failure. <br />The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require <br />that the language of this certification be included in all lower tier subcontracts, which exceed. S100,000 <br />and that all such subrecipients shall certify and disclose accordingly: <br />Signed: - r <br />n �= <br />Title; S - art%{ 1 <br />" <br />Firm: I/,,f. ,.�.. L •. �'. !off _' t` , /fl_ J <br />bate: <br />City of Santa Ana RFP 18-009 <br />___ 261-88 <br />
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