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CITY OF SANTA ANA► <br /> i <br /> ( 3 <br /> Na N 11L Y�■y}y �y fM� _ rj.i }��1 t <br /> The prospectivo participant oartifies,by signing And submitting this bid or proposal,to the boat of his or <br /> her knowledge and belief,that, <br /> (1) No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned, <br /> to any person for influencing or attempting to influence an officer or employes of any Federal <br /> agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member <br /> of Congress In connection with the awarding of any Federal contract,the making of any Federal <br /> grant the malting of any Federal loan,the entering Into of any cooperative agreement. and the <br /> extension,continuation,renewal,amendment,or modifloatfon of any Federal oontraot,grant,loan, <br /> or cooperative agreement, <br /> (2) If any Bands other than Fodoral appropriated funds have Wen paid or will be paid to any person <br /> for Influencing orattempting to influence an officeror employee of any Federal agency,a Member <br /> of Congress, an officer or employee of Congress, or an ernployeo of a Member of Congress In <br /> connection with this Fodoral contract, grant, loan, or cooperative agreement, the undersigned <br /> shall complatb 'arid subrrilt Standard Forth-1"1*t., "alsclosure of Wbbyfng Activities," in <br /> conformance with Its instructions. <br /> 'Phis 66rtlfication is atidtb'rihl-represenlation of fact upon whioh rellanee was placed when tilts transaction <br /> was made or enterbd'into. Submission of this certification Is a prerequisite for making or entering into <br /> thin troosbiction Imposed by Section 1352,'title 31, U.S.Code. Any person who fails to file the required <br /> certification shall be subject to a civil penalty of not less than$10,000 and not more than $100,000 for <br /> each such-failure. <br /> Tho prospebfive participant l lso agreed by submitting his or her bid or proposal that he or she shall <br /> squire that-the language of this certiflgatlon be included in all lower tier subcontracts, which exceed <br /> $100,000 and that all such subreoiplents shall cortify and disclose accordingly. <br /> Signed: <br /> Title: PRESIDENT <br /> Firm:.- ABAJIAN ENTERPRISE <br /> Date: f Sz <br /> i`HIs M1�.,M T f?1kIPt ` E—D AND <br /> 1J r ;� pJzr PQt AL. <br /> PROPOSAL,I THAT ISO NOT CONTAIN T HIS J ORM WILL BE 0. Nl3WIE;f31ER NONRESPONSIVE <br /> Cilyof Sala Arse Rf`P No.2027 Page 37 of Al I <br /> 12 ! <br />