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Certification Re,ardiny7 Lobhving <br />Certification for Contracts, Grants, Loans, and Cooperative A17reemerlts <br />Tbc unetersi -Oned certifies, to the hest ofhis or her I�no« led =e and belief; that <br />I t -\n Federal appropriated funds have been paid or will be paid, by or on behalf ofthe <br />al>>t rsl` ned. to any. person f 7r infiuencinty or attemptina to influence an officer or <br />err r!(-o% cc of ally agency <l vlember of "ont <br />`Iess, an Officer or tml?l()t "et t)f ;)11gresti. or <br />3I? c'Tn114_7l'et of a Member of Cf tn`gress in connection wltll the aw ard I'll C, of anv Federal <br />E 0ntract the ma inL cof anv cooperatn't: ,l;Yrec'rlent, and the extension- continuatinn_ <br />• Lt _tt. <1111,zndrl rl. t_,.r l—no. Illld ­lilt 111 0.1 cI11L 1'Cll C1? f - --,+ <br />11 et ?t ltcle L, �MJIIL, tna11 O l.l`t t1 Gl cell Fie <br />1��tery)clnt. <br />if 11;v funds other than Federal appropriated funds have been paid or "ill he paid to <br />1n,.- person 'or influencing or attempting to influence an officer or emplovee of any <br />LCnlutr f CoYIgres)_ an t)rilcer or ernDlT)� ee Of (�t__in—grt5S. (I an eY21171(�Vee Of j <br />lernlher of( ontT resS In connection with this Federal contract, LTraIlt_ loan, or cti(7l?edatrt-e <br />1�rceT1)ent_ the und er - siuned shall complete and submit Standard Form -LLL_ "Disclosure <br />l ;Ire to Report Lobbvtm.,," in accordance �L�v th its instructions, <br />' nc Undersigned SiLt.aH r uuIre th <o tite'angu`l if tells curti�it tti ri be lili ? C12d ill :lie <br />M al d dl_ cuments for all suba A ards at all tiers (lncludina subcontract, subgrants, and <br />Cont; acts Under - arafts, loans. and cooperative a�`reernents l and that all sUl?rc'c11�1entS shad <br />eeroli< illd disclose aceordinaiv <br />c:ertllkatil>n is a material ,representation Of !-act upon which reliance Iv; is De iced <br />t1 1C -il Ll lid Ll a l-� Cl. C LI I-rA Y\ CIS 11.Lj tf. l/i L.:1rLCr Clf. 11110 i' 141^1 <br />U 1111)s1'Jil i_)1. L111S lei{ lll Clcl. 11 :. n Is a <br />(?rc'ic` (tl?slte for makin-g or entering into this transaction lmpl)sed h- Section i ��. 71tie <br />l `odC . :'env person who f, Is to file the required certification shall be sub ect to <br />I clvd pcnalty ol`not less than SIH,( 0i) and not more than a }tll),ili_i(;t for each such failure. <br />["amt of 'ertltving Officer - <br />5 ianature h< it: <br />HX1 I [B IT C <br />Page 1 of <br />