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
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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)
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of asthems a
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.
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Telepboue No.;
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as We $111,IM ass w mon Om S1M,IM foie w rants•
. Date:
FgdMrr! a L{ieralp
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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.