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g 'n� t' nay : tracts t'*ants tn�onerativeAaxeements <br />The undersigned certifies, to the beat of his or her knowledge and belief, that: <br />(1) No Federal appropriated funds have 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 of any agency, a Member of Congress, an officer or employee of Congress, or <br />an employee of a Member of Congress in connection with the awarding of any Federal <br />contract, the making of any cooperative agreement, and the extension, commuatle14 <br />renewal, amendment, or modification of any Federal contact, grant, loan or cooperative <br />agreement. <br />(2) if any funds other than Federal appropriated funds have been paid orwill be paid to <br />any person for influencing or attearpttng to influence an officer or employee of any <br />agency, a Member of Congress, an officer or employee of Congress, or an employee of a <br />Member of Congress in connection with this Federai contract, grant, loan, or cooperative <br />agreement, the undersigned shall complete and sebmit Standard Form LLL, "Disclosure <br />Form to Report Lobbying," In accordance with its Instructions. <br />(3) The undersigned shall rquire that the language of this certification be included in <br />award documents for all subawards at all tiers (Including subcontract, subgrants, and <br />contracts under grants, loans, and cooperative agreements) and that all subrecipients>shall <br />certify and disclose accordingly. <br />This certification is a material representation of faerupon wlrichreliance was placed <br />when this transaction was made or entered into. Submission of this certification is a <br />prereq*lte for maldng or entering into this transaction imposed by Section 1352, Title <br />31, U. S. Code, Any person who fails to file the requlted certification shall be subject to <br />a civil penalty of trot less than $10,000 and not more than $100,000 for each such failure. <br />nC r!A '_ l vt oY,4z. 'C:oWj OmIs <br />Grantee/Contactor Organization Program Title <br />M <br />EMUBITD <br />Page I of 2 <br />