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DMF/fm <br />1/22/91 <br />CERTIFICATION REGARDING LOBBYING <br />CERTIFICATION FOR CONTRACTS, GRANTS, LOANS <br />AND COOPERATIVE AGREEMENTS <br />The undersigned certifies, to the best of his or her knowledge and <br />belief, that: <br />(1) No Federal appropriated funds have been paid or will be paid, <br />by or on behalf of the undersigned, to any person for influencing <br />or attempting to influence an officer or employee of an agency, a <br />Member of Congress, an officer or employee of Congress, or an <br />employee of a Member of Congress in connection with the awarding of <br />any Federal contracts, the making of any Federal grant, the making <br />of any Federal loan, the entering into of any cooperative <br />agreement, and the extension, continuation, renewal, amendment, or <br />modification of any Federal contract, grant, loan, or cooperative <br />agreement. <br />(2) If any funds other than Federal appropriated funds have been <br />paid or will be paid to any person for influencing or attempting to <br />influence an officer or employee of any agency, A Member of <br />Congress, an officer or employee of Congress, or an employee of a <br />Member of Congress in connection with this Federal contract, grant, <br />loan, or cooperative agreement, the undersigned shall complete and <br />submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in <br />accordance with its instructions. <br />(3) The undersigned shall require that the language of this <br />certification be included in the award documents for all subawards <br />at all tiers (including subcontracts, subgrants and contracts under <br />grants, loans, and cooperative agreements) and that all <br />subrecipients shall certify and disclose accordingly. <br />This certification is a material representation of fact upon which <br />reliance was placed when this transaction was made or entered into. <br />Submission of this certification is a prerequisite for making or <br />entering into this transaction imposed by 31 U.S.C. 1352. Any <br />person who fails to file the required certification shall be <br />subject to a civil penalty of not less than $10,000 and not more <br />than $100,000 for each such failure. <br />Grantee/Contractor Organization Program Title <br />Name of Certifying Official Signature Date <br />ATTACHMENT A TO EXHIBIT II <br />