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Local Assistance Procedures Manual EXHIBIT 12-E <br />PS&E Checklist Instructions Attachment F <br />ATTACHMENT F NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS <br />The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her <br />knowledge and belief, that: <br />(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any <br />person for influencing or attempting to influence an officer or employee of any federal agency, a Member <br />of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection <br />with the awarding of any federal contract, the making of any federal grant, the making of any federal <br />loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, <br />amendment, or modification of any federal contract, grant, loan, or cooperative agreement. <br />(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for <br />influencing or attempting to influence an officer or employee of any federal agency, a Member of <br />Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection <br />with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and <br />submit Standard Form -LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. <br />This certification is a material representation of fact upon which reliance was placed when this transaction was <br />made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction <br />imposed by Section 1352, Title 31, U.S. Code. Any 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 than $100,000 for each such failure. <br />The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the <br />language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such <br />sub recipients shall certify and disclose accordingly. <br />Page 12-33 <br />OB 12-04 June 29, 2012 <br />