HomeMy WebLinkAboutLobbying Certificate 2CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid, or will be paid, by or an behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any
ny
Federal ive agreement,
me maki,andgthOe extension, r col ntinuatint, le on, rrenewal, aaking of mendmentalorloan,
modifcatitonrtng into of any
of any Federal
cooperative agreement, an
contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid to any person 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 of Congress in connection with this Federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure; Form to Report
Lobbying," in accordance with its instructions.
(3) This undersigned shall require that the language of this certification be included in the award documents for
"All" sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative
agreements) and that all sub -recipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a pre -requisite for making or entering into this transaction
imposed by Section 135� f not Title
than 510,000 and notmore than 5144,400 foreacli
lllperson
file
required
fa lure certification shall be
subject to a civil penalty
,Tamps; F. Soot t Cnmmuni ty Asgnci a t i on
APPLICANT
Dorrin D. Rolle
PRINT NA OF CERTIFYING OFFICIAL
SIGN URE 0
1NG OFFICIAL
3/% 4) S�
DATE
• Note: these instances, "All" in the Final Ruleis expectedflto be clarified to show that it applies to
covered contract/grant transactions over S 100,000 (per
Q ).
City of MIAMI STATE OF FLORIDA
The forgoing instrument was acknowledged before me this day of MARCH , 2005
by Dorrin D. RQQlle as President & CEO (title)
(name of person whose signature is being notarized)
of;.MES E. SCOTT COMMUNITY ASSQCIATION, INC, known to me to be the person described herein,
(name of corporation/company)
or who produced X as identification, and who did/did not take an oath.
(Type of Identification)
NOTARY PUBLIC:
Althea C. Jackson My commission expires July 10.2007
(Print Name)
SEAL
�oaf \ Mhos C. Jackson
• My Commission D0231073
Expire; July 410e7