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HomeMy WebLinkAboutattachmentBATTACIIMENT B DISCLOSURE OF LOBBYING ACTIVITIES Couplets ibis farm to dbalaa lobbylnj atativillsr pursuant to 31 U.S.C.1331 CS* rove. or public bards. disclaun.) Appromd by OHM 03484044 1.❑Typo �` of ?Mond Aspect a. ca.tfscl b. gram c. cocparatl.s spittoon IL loan o. tom guaroota f. loos Worms 3. Status ❑ of Mani Adios' a, blNoffrriapplicsUoo b. I.ldal swud {, p0lbaWard 3.. Repori Typo ❑ a. Weal fibs b. malarial Moor For Material Change Only: year quarter. dots of Iasi raper 4. Noma one Addroos of Reporting Entity: r ,.., . .i El Prime ti Snowards. Tlsr . ((Mown.' S. If Reporting Entity la No. d h SubawerdN, Einar Noma „�"`"" • ' aitd' AddreM of Prmaet" ... ..., ..., , . • Coograadattal District, j/known: C.agr.uloul District, (f knows: ii Fedora! DepartmieWAgtucl': . 7. Faders! Program Nlm&Dasciipdo:r: CFDA Number; (f appllrabler• 0. Fedora! Action Number, ((Mown.. !. Award Amount, ((known: $ 10. a. Now sad Addrou of Lobbying EatIty (jf lndiv(dunl, but some. first none, M1) farrack Continuation Sheens;) b. ladkrkdutie PMonitIng Ssrvlsu f inclndin! address (f d(ferent jroal No. 1Da) (lair name, first names, MI) • + SF L LLA, !f Rer arv) Olinotures IL tahrsilllgs roommd the 1* w.. lo cremes sd l7 UUI 11 t?.LC. walks WI, Ms d114iss.ro y4lywe is assararial of asthems a plus Noma fgri su!141 s m hid, ups id* milisse vet Oloall h• OM Orr abw. WO Ibis Mggllatiee ew.NN or saMM Mlrr,' bh ilediewo b regult.d WNW w 31 V.&C 13f11 bliespettio w'Of M N inid. w Gilroy' . 11At: suo i•ous any cad ell boantra bli the osiblia,IMpsolha Aar Petal wba Mk is dk Os r.goltoe IM IIIWI Moe be memo w di of oaf Telepboue No.; u mushy as We $111,IM ass w mon Om S1M,IM foie w rants• . Date: FgdMrr! a L{ieralp d farbane: rcos l !alpha fora- uL Min 1 rla7) Form DEP D5-111(01/01) DEP AOresm.n* No. LW402, Attachmeol 13, Page 1 of 2 -11111=1 'INSTRUCTIONS FOR COMPLETION OF SF.LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the latit(ation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing or a form Is required for each payment or agreement to make payment to any lobbying entity for Influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member or Congress In connection with a covered Federal action. Complete all !tens: that apply for both the Initial thing and material change report. Refer to the impieaaentiag guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity to and/or has been secured to Influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a foilowup report caused by a material change to the information previously reported, enter the year end quarter In which the change occurred. Enter the date orthe' lilt 'p svIo i11y isutitliitted riPsort'b f the Ye) ttfng'etttity 'for 'this covered Federal action. 4. Enter the full name, addrus, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if It le or expects to be, a prime or, subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prima is the 1st tier. Subawerds Include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4. checks "Subawardee", then enter the futi name, ■ddress, city, state and tip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency Working the award or loan commitment. Include at least one organizational level below agency name, If known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, louts, end loan commitments. 8. Enter the moot appropriate Federal identifying number available for the Federal action Identified In Item I (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant arunouncement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP•DE•90.001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified In item 4 or 5. I0. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified In Item 4 to influence the covered Federal action. (b) Enter the hull names of the individual(s) performing services, and Include full addresv if different from 10 (a). Enter Lut Name, First Name, and Middle Initial (MI). Il. The certifying oMclal shall sign and date the form, print his/her name, title and telephone number. According to the paperwork Reduction Act. as intended, no persons ere required so respond to a collection of Iarormetioa unless It diepteyr a valid OMR Control Number. The valid OMS control number for tills Informative collection le OHM No. 034114104e. Public reporting burden for We collection of information Is estimated to average 30 minutes per response, Including time for reviewing hutrvctions, marching existing dais scurrra, talhertnt and maintaining the data needed, and completing and reviewing the collection of Mier:Whin. Send comments regarding the burden militate or any other aspect of Ibis collection of information, Including imitations for reclusion this burden. to the Otflce of Man_apmsnt and lludset, Patserrrerk Reduetion Protest t0341.0045), Wa Ilan, D.C. 30503, Form DEP S5.221 (Oiiul ) DEP Agreement No. 04'461, Attachment B. Page 3 of 2 r�ataynw INSTRUCTIONS FOR CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION• LOWER TIER FEDERALLY FUNDED TRANSACTIONS I. By signing and submitting tide foam, the certifying party is providing the unification set out below. 2. The certification in this clause Is a material representation of fact upon which reliance was placed when this trartsecrion was entered into. , Jf tt to later determined that the certifying party knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Oovernment, the Department of Environmental Protection (DEP) or agencies with which this transaction originated may pursue available remedies. including suspension and/ordebarment, 3. The certifying party shall provide inenediete written notice to the person to which this contract is submitted if at any time the ceniyi4I puny 'elite that iti ccntileiIJon• vial' erroneous when 'submitted or hie Worts 'erioneouby i lion 'br Winged' ...... - circumstances. 4. The terms covered transaction, debarred, suspended, ineligible,, lower tier covered transaction, participant, person, primary covered transaction. principal, proposal, and voluntarily excluded. u used in this clause. hive the meanings set out in the Definitions and Coverage sections *Mules implementing Executive Order 12549. You may contact the person to which this contract is submitted for usistance In obtaining a copy of those regulations. 5. The certifying party agrees by submitting this contract that,should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier contract, or other covered transaction with a pawn who.ls proposed for debarment under 41 CFR 9, . subpart 9.4, debarred, suspended, declared ineligible. or voluntarily excluded from participation in this covered . traruaction, unless authorized'by the DEP or agency with which this transaction originated. 6. The certifying parry further agrees by executing this contract that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction,' without modification, in all contracts or lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it it not is proposed for debarment under 411 CFR 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its ,principals. Each participant may, but is not required to, check the Nonprocurement List (Telephone No. (202) 501.4740 or (202) 501.4173.) g, Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the eenifiesuion required by this clause. The knowledge and information of a participant is not required to exceed that which is normally ;moaned by a prudent person In the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant In a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR 9, subpart 9.4, suspendeJ, debarred, ineligible, or voluntarily excluded from participation in this ul,utsnution, in addition to other remedies available to the Federal Government, the DEP or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. DEP FORM 55.220.(0110]) Pala 2 at2 }'• N p+ 47.. DEP Agreement NO, LW462, Attachment S;, Page 2 of 2 Exhibit J crry OF MUM CAPITAL IMPROYDiMEN1PROGRAM 1, The City shall pay DOSP on a reimbursement basis only and only for those authorized ErWeet Costs. as identifiecJin approved pursuant to the Prajgt.._ In order for DOSP to be e and reasonable for thoeffective and efficient accomplishment of the Project and must die tjirectiy allocable thereto, 2._ REBURSBMBNT PROCEDURES: pQSP shah submit iti expenditures to the OSP will further submit a_navment requisition signet and t oved_bv the contractor the Arohitut and QO$P to the City for payment, Payment reouisitions shall o mnJy with ail requirements for disbursement as contained in the Agreement and as maybe required by the City. Such requireenents Inclu�b re not limited to, a statement oldie following: total proJept ceat to date. change orders to date the schedule of values contained within ;hp construction bpgt clew ado tote. the aft gf the,pavmcnt request, the struction right to file a lien egging the improvements to the extent the claim was coxered by u previous munition. together with such other lien waivers. releases. or evince Qf naymottt as the City may, require: ant(.(»1 vat en c rt fication �,e Architect that t1 e information contained in the requisition for Dement it acoutate, and that the work covert by jLreguisition was comae in accordance with the aprnved plans: and (fill Buch other documentation as may be reasonably required by the City. Lloon approval of the requisition by the City, the City shall remit the fund to DOS?, 1 _ _ .NONCOMPLIAN1BThe City shall have Q ght to reimbursement__ either i„ whole or part as it. as it may determine, of the funds provided hereunder fir nencampliance by City or_DOSE with env old); terttts of the Agreement, Ueon notification from theCity, p9SP shall reimburse such fluids directly to the City. The revisions of this paragraph shall survive completion of QQnstruction of the Parking Facilities, 4, DO4P'i LIAISON — DOSP shall appoint a liaison whom tlame_end title shah b9 submitted to the City upon execution of the Amendment. to act on behalf of DO5P relative to the provision§ Qf this Agreement 5. STATUS REPORTS — DQSP's Liaison shall submit to the_ City Project status reigirts ¢uringJhe construction of the Baywalk. Restroorn- facilities end all other related mods _pqrspant to the Agreement. The reports are to be on the forms provided by the itv's Department cif tic Development. Project design drawines, enainccting swings. and a spy of the Project bid award construction item cost list will tie submitted as available. Photographs shall be submitted when appropriate to reflect dig w_grk accomplished. Non-compliance by DQSP with the reporting requirements may result in termination ofthisAjreement, 6. The City shall have the rat to withhold any payment funded through the City of Miami Capjjaj Improvement Program. either in whole or earn for non-compliance with the - of this Agreement, 0 Development_ receipt of DOSP's invoice. which shall be accompanied by_ sufficient supporting documentation and contain sufficient dotal to allow a proper audit of expenditures. shqqldCity_require one to be performed.