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C'eni6cttion Regsrdin¢ Lobbying <br />Certification for Contracts. Grants, Loans. and CouueratkeAuic•m°nt' <br />The Undersigned certifies, to the best of his or her knowledge and belief, that <br />(1) No Federal appropriated Funds hate been paid or will be paid, by or on behalf of the <br />undersigned, to any person for influencing or attempting to influence an officer or <br />employee orany agency. a Member of Congress, an officer or employee of Coiigres;, or <br />an employee or a Member of Congress in connection with the im arding, of any Federal <br />contract, tin making of any cooperatice agreement. and the extension, continuation, <br />renencal, amendment. or modification of ally Federal contact, grant, loan or cooperative <br />aucentent. <br />(2) Iranfunds otherthan Federal appropriated Fund; have been paid or will be paid to <br />anc person for influencing or ❑rtennpting to influence an officer or employee of any <br />sn_encv. a Member of Congress. all officer or employee of Congress, or an employee of a <br />Member of Congress in connection with this Federal contract, tram, loan, nr cooperatice <br />agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclasure <br />Fm'm to Report Lobbying." in accordance a ith its instructions. <br />(,) fhe Undersigned shall require thm the langua_ec of this certification be uncluded in the <br />aM:lyd documents for all suhawards at all tier, (including .subcontract. suburants, and <br />contract, uniler grant:, loans. and cooperative agreements) and that all subrecipients shall <br />cartifv and discloie accordingly. <br />This certification is a material representation of fact upon which reliance gas placed <br />%hell this transaction %Uas made or entered into. Submission ofthis certification is a <br />prerequisite for making or entering into this transaction imposed by Section l3i2, "Rifle <br />31, U. S. Code. .Am person who fails to file the required certification Mull be Subject to <br />I cis it penalty of not less than S 10.000 and not more than SI00,000 for each SUCK failure. <br />{ lc �Ltitt�S' 041t� l(�ct1f 1 <br />Grantee Contactor Org:mitation <br />Program lie <br />Name of Cc•rtift•ins Officer Signature Date <br />FAIIIBIf D <br />Pact I of <br />