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<br /> ~. ~ . <br /> CERTIFICATION REGARDING LOBBYING S7x' <br /> CERTIFICATION FOR CONTRACTS. GRANTS, LOANS AND COOPERATIVE AGREEMENTS <br /> The undersigned certifies, to the best of hiš or her knowledge and belief <br /> that: <br /> (1) No federal appropriated funds have been paid or will be paid, by <br /> or on behalf of the undersigned, to any person for influencing or <br /> attempting to influence an officer or an employee of any agency, <br /> a member of congress, an officer or employee of congress, or an <br /> employee of a member of congress in connection with the awarding <br /> of any federa 1 contract, the making of any federal grant, the <br /> - making of any federal loan, the entering into of any cooperative <br /> agreement, and the extens i on, cont i nuat ion, renewa 1, amendment f <br /> or mod i f i cat i on of any federal contract, grant, loan, or <br /> cooperative agreement. <br /> (2) If any funds other than federal appropriated funds have been paid <br /> or will be paid to any person for influencing or attempting to <br /> influenc~ an officer or employee of any agency, a member of <br /> congress~ 'an officer or employee of congress, or an employee of a <br /> member of congress in connection with this federa 1 contract, <br /> grant, loan, or cooperative agreement, the undersigned sha 11 <br /> complete and submit Standard Form-111, 'IDisclosure Form to Report <br /> Lobbying,1I in accordance with its instructions. <br /> (3) The undersigned sha 11 require that the language of this <br /> certification be included in the award documen.ts for all <br /> subawards at all tiers (including subcontracts, subgrants, and <br /> contracts under grants, loans and cooperative agreements) and <br /> that all subrecipients shall certify and disclose accordingly. <br /> This certification is a material representation of fact upon which reliance <br /> was placed when th i s transacti on was made or entered into. Submission of <br /> this certification is a prerequisite for making or entering into this <br /> transaction imposed by Section 1352, Title 31, U.S. Code. Any person who <br /> fails to file the required certification sha 11 be subject to a civi 1 <br /> Jenalty of not less than $10,000 and not more than SlOO,OOO for each such <br /> ¡ failure. <br /> / /1 'M' <br /> 0 Date <br /> Name of Authorized Individual '7Lf~O6;;¿~Y"f 91-6 I <br /> Application or Contract Number <br /> Name and Address of Organization <br />