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Appendix <br />AT I'ACHNIENI' 4-2: NON -LOBBYING CERTIFICATION <br />CERTIFICATIONS <br />the prospcctive participant ecrtiftes. by sigmnig, and submitting [his hid or proposal, to the hest of his or her <br />knowledge and belief, that: <br />No Iederal appropriated lunds have been paid or will be paid. by or on behalf of the undersigned. to <br />any person for influencing of attempting to influence an otticer or anployce irtany tederal agency, n <br />MCI IIher oIYbngr c.'s' an I) Ili cer or ernployec of Cun,�-es, or an crrip] oycc of a Mcrnhcr of Congres <br />in comtcclion with the awarding of any fcd(mjl contract, the rr> dung of any fcdcral grant, the snaking <br />of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, <br />renewal, amendment, or modification of any tederal contract, grant, loan, or cooperative agreement. <br />2_ If irny funds other than federal appropriated funds have horn paid or will be paid to any person for <br />influencing or attempting ro inflilcuce any of ccr or uTiployce of any federal agency. a MCr11bCr of <br />n Cogress, an officer or canploycc ofr an Congress, ocinploycc of a. Me <br />mber of Congress in <br />connection with this federal contract, grant loan, loan or cooperative agrG;mcnt, the undersigned <br />shall complete and submit a -`Disclosure of Lobbying Activities". <br />This certification is a material representation ol'tact upon whic}t reliance was placed when this transaction was made <br />it cnTUI L:d into. Submission of thin cc titicotioII k a pra2Xlui fte fin' making or entering into this traruaetioII impirs'cd <br />by Scetion 135"_>, Title 31, U. S. Coda Anv pu�ion who fail-s to file the rcyuircd cc7-tificanon zhall be subjuvl to a civil <br />penalty of not Icss than S101000 and not more than S 100,000 for each such failure. <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 tier Subcontracts, which exceed S 100,000 and that all such sub <br />rccipiontc shall certify and diRelosc accordingly_ <br />Firm <br />Signed and P intcd Namc- <br />Irnn <br />nitre <br />City Council City of Santa Ana -2t$ 49 6 202 <br />Page A4-2 <br />