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The prospective participantcertitios, by signing and submitting this bid or ixoposal, to the bestofhis or her <br />knourledge and belief, that: <br />I- No fedoras appropriated funds have been paid or will bepaiti, by or onbehatfoftheundataigned, to <br />any person for Influencing or attempting to influence an ofIlecr or employee ofany federal agency, a <br />Member ofCongress, an officer or employee of Congress, or an employee ofitMember ofCongress <br />in connection with the awarding of any fedand contract, the mWdngofany, federal grant, the muidog <br />ofanyfederal loan, the entering Into ofany cooperative agreement,and the wdonsion,coulmustion, <br />renewal, amendment, or modification ofany fe&ml contract, Snug, loan, or cooperative agreement. <br />2. Ifany funds other than fedora( appropriatedfimdshave been paid or will be paid to any person for <br />Influencing orattempting toInfluence any officer or employee of any fodend agency, aMember of <br />Congress, an Officer or employee of Congress, or an employee of a Member of Ccngrass in <br />carmection with this federal contract, grantloan, loan orcooparative agreamont, the undersigned <br />shall complete and submit a"Disclosure ofLobbying Activities"'. <br />This certification Is a material representation of fact upon which reliance was placed when this transaction was made <br />or entered into. Submission ofthis certification is a preretlalsite for makhtg or entering into this transaction imposed <br />by Section 1352, Title 31, U. S. Code. Any person who falls to filo therogWmd certification shall be subject to a civil <br />penalty of not less than $10,000 and not more than $100,000 for each such faitaro. <br />- The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the <br />language of this certification be Included in all lower tior subcontracts, which oweed $100,000 and that all such sub <br />recipients shalt certify and disclose accordingly, <br />Firm, r �%CxK Ty'%00%L�5 CAV%d. GOrw?errvi ir-�L® <br />Signed and Printer( Name: <br />Thle, li ;s,tdC:r\�r <br />Date Ih ch - cy-, 13 t t U t <br />City of Santa Ana ttF- <br />page A5.2 <br />25E-641 <br />