Laserfiche WebLink
Local Agency Certification for Federal-Aid Contracts <br />The prospective participant certifies by signing and submitting <br />this bid or proposal, to the best of his or her knowledge and <br />belief, that: <br />(1) No Federal appropriated funds have been paid or will be paid, by or on <br />behalf of the undersigned, to any person for influencing or attempting to <br />influence an officer or employee of any Federal agency, a Member of Congress, <br />an officer or employee of Congress, or an employee of a Member of Congress <br />in connection with the awarding of any Federal contract, the making of any <br />Federal grant, the making of any Federal loan, the entering into of any <br />cooperative agreement, and the extension, continuation, renewal, amendment, <br />or modification of any Federal contract, grant, loan or cooperative agreement. <br />(2) If any funds other than Federal appropriated funds have been paid or will be <br />paid to any person for influencing or attempting to influence an officer or <br />employee of any Federal agency, a Member of Congress, an officer or <br />employee of Congress, or an employee of a Member of Congress in connection <br />with this Federal contract, grant, loan, or cooperative agreement, the <br />undersigned shall complete and submit Standard Form-LLL, “Disclosure Form <br />to Report Lobbying,” in accordance with its instructions. <br />This certification is material representation of the fact upon which reliance was <br />placed when this transaction was made or entered into. Submission of this <br />certification is a prerequisite for making or entering into this transaction imposed <br />by Section 1352, Title 31, U.S. Code. Any person who fails to file the required <br />certification shall be subject to a civil penalty of not less than $10,000 and not <br />more than $100,000 for each failure. <br />The prospective participant also agrees by submitting his or her bid or proposal <br />that he or she shall require that the language of this certification be included in <br />all lower tier subcontracts, which exceed $100,000 and that all such <br />subrecipients shall certify and disclose accordingly. <br />DOT Form 272-040A EF <br />07/2011 <br />SR