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Appendix A7"I'ACIIML',N'1' 3-2: NON -LOBBYING ('ER'1'11 IC'A'I'ION CERTIFICATIONS The prospective. parlicipatn cerlifics, by gigging and subtnittin_u [Iris bid or proposal, to the best of his or her knowledge and belief, that: I . No federal appropriated funds have been paid or wi II be paid, by or on behaI f ol'lhe undetsi�ged, to any person litr ill lluatcin" or attempting to inlluatec an officer or nnploycc ofany federal agency, a Member of C'ongtess, an officer or cmploycc of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making ofany federal grant, the malting of any tederal loan, the entering into of any cooperativec agtumcm, and the cx[ension, continuation, icn ewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. It any funds other than federal appropriated funds have been paid or will be paid tit any Pei -soil for intluencing or attempting to influence any officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant loan, loan or atoperative. agrocment, the undersigned shall complete and submit a "Disclosure of Lobbying Activities". This certification is a material representation of fact upon which reliance was placed when this transaction wag made or entered into_ Submission of this cern Gcation is a prerequisite for making or entering into this transaction imposed b_y Section 1352. Title 31, U. S. Coda Any person Who fails to file fttc required certification shall be subject to a civil penalty of not less than $10,000 and not more than S100.000 for each such to Ilul-c_ The prospective participant also agyees by submitting his or her bid or proposal that he or she shall regtute that the language of this certification be included in all lower tier subcontracts, which exceed S t 00,000 and that all such sub rceipipvs shall certify and disclose accordingly. Firm Signed and Printed Name. Title Date. City Council 26 — 39 6/15/2021 City of Santa Ana RIP 21-004 Yagc A3-2