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DocuSlgn Envelope tD: 994D7BG4-AGE8-44B9-B863-2D49AC073F7A <br />CITY OF SANTA ANA <br />ATTACHMENT E <br />NON�LOBBYING 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 funds 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 making 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,.loan, <br />or cooperative agreement. <br />(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person <br />for influencing orattempting to influence an officer or omployee of any Federal agency, a Member <br />of Congress, an officer or employee of Congress, or an employee of a Member of Congress in <br />connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned <br />shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities, in <br />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 <br />this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who falls to file the required <br />certification shall be subject to a civil penalty of not loss than $f 0,000 and not more than $100,000 for <br />each such failure. <br />The prospective participant also agrees by submitting his or her bid or proposal that he or she shall <br />require that the language of this certification be included in all lower tier subcontracts, which exceed <br />$100,000 and th tall su subrecipients shall certify and disclose accordingly. <br />Signed: �h f <br />Title: Manager of Security Service and Solutions <br />Firm: Siemens Indust Inc. <br />Date: 5/28/20 <br />1'HIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL, <br />PROPOSALS THAT' DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />RFP Alo, 20.053 Video Surveillance System Maintenance and Nepali, Services Page 39 of 41 <br />