HomeMy WebLinkAboutExhibit10EXHIBIT F
CERTIFICATION 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 on 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
Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal
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 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be
subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
NAME OF APPLICANT
PRINT NAME OF CERTIFYING OFFICIAL
SIGNATURE OF CERTIFYING OFFICIAL DATE
* Note: In these instances, "All" in the Final Rule is expected to be clarified to show that it applies to
covered contract/grant transactions over $100,000 (per QMB).