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ChildStrive 4/5/2022
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6 Years Then Destroy
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ChildStrive 4/5/2022
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Last modified
5/6/2022 9:36:00 AM
Creation date
5/6/2022 9:34:53 AM
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Contracts
Contractor's Name
ChildStrive
Approval Date
4/5/2022
Council Approval Date
10/27/2021
End Date
12/31/2022
Department
Administration
Department Project Manager
Tyler Chism
Subject / Project Title
Everett Forward Grant Madres de Casino Rd
Tracking Number
0003331
Total Compensation
$33,000.00
Contract Type
Agreement
Contract Subtype
Grant
Retention Period
6 Years Then Destroy
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Exhibit H: Lobbying Certification <br /> The undersigned certifies, to the best of the undersigned's knowledge and belief, that: <br /> (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any <br /> person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an <br /> officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any <br /> Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any <br /> cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal <br /> contract, grant, loan, or cooperative agreement. <br /> (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing <br /> or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee <br /> of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or <br /> cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to <br /> Report Lobbying," in accordance with its instructions, as attached. <br /> (3)The undersigned shall require that the language of this certification be included in the award documents for all <br /> subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative <br /> agreements) and that all subrecipients shall certify and disclose accordingly. <br /> This certification is a material representation of fact upon which reliance was placed when this transaction was <br /> made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction <br /> imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject <br /> to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. <br /> I hereby certify that I have read the above certification, and that the information and my statements provided <br /> herein by me are true and correct to the best of my knowledge, and by my signature on this document, <br /> acknowledge my understanding that any intentional or negligent misrepresentation or falsification of any of the <br /> information in this document could subject me to punishment under federal and/or civil liability and/or in criminal <br /> penalties, including but not limited to fine or imprisonment or both under Title 18, United States Code, Sec. 1001, <br /> et seq. and punishment under federal law. <br /> r <br /> Mary Cline-Stively /` f AI; <br /> ,J <br /> Printed Name Signature <br /> CEO 3/25/2022 <br /> Title Date <br /> irEVE R E T T Everett Forward Grant Program Subrecipient Agreement Page 22 <br /> unill WASHINGT©N <br />
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