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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, toany 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 /> > . _ or rri ki o or _ .I o .. r_ 9$ imposed <br /> - ny •o _.. <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 submittinq his or her bid or proposal <br /> that he or she shall require that the language of this oertifibation be includedin <br /> all lower tier subcontracts, which exceed $100,000 and that all such <br /> subrecipients shall certify and disclose accordingly. <br /> SR <br /> DOT Form <br /> 071201 272-040A1 EF <br />