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• COOPERATIVE <br />1) No Federal appropriated funds have been paid or will be paid, by or on behalf of <br />the undersigned, to any person for influencing or attempting to influence an <br />officer or employee of any agency, a Member of Congress in connection with the <br />awarding of any Federal contract, the making of any Federal grant, the making of <br />any Federal loan, the entering into of any cooperative agreement, and the <br />extension, continuation, renewal, amendment, or modification of any Federal <br />contract, grant, loan, or cooperative agreement. <br />IMPOSE <br />} ♦ } i i } <br />each such failure. <br />t aul <br />Name of Certifying Official Signature <br />r <br />Ac i Nymid <br />Program Title <br />