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CITY OF EVERETT PUBLIC WORKS <br /> SPECIAL PROVISIONS <br /> CERTIFICATIONS AND REPRESENTATIONS <br /> (CONTRACT FUNDS) <br /> BYRD ANTI-LOBBYING AMENDMENT COMPLIANCE AND CERTIFICATION <br /> For all orders above the limit prescribed in FAR Section 52.203-12(g),or its successor regulation <br /> (currently$150,000),the Offeror must complete and sign the following: <br /> The following certification and disclosure regarding payments to influence certain federal transactions are <br /> made per the provisions contained in FAR 52.203-11 and 52.203-12 and 31 U.S.C. 1352, the "Byrd Anti- <br /> Lobbying Amendment." <br /> (a)FAR 52.2.03-12, "Limitation on Payments to Influence Certain Federal Transactions"is hereby <br /> incorporated by reference into this certification <br /> (b)The offeror, by signing its offer, hereby certifies to the best of his or her knowledge and belief <br /> that: <br /> (1)No Federal appropriated funds have been paid or will be paid to any person for influencing or <br /> attempting to influence an officer or employee of any agency, a Member of Congress, an officer <br /> or employee of Congress, or an employee of a Member of Congress on his or her behalf in <br /> connection with the awarding of any Federal contract,the making of any.Federal grant,the <br /> making of any Federal loan,the entering into of any cooperative agreement, and the extension, <br /> continuation, renewal, amendment or modification of any Federal contract, grant, loan, or <br /> cooperative agreement; <br /> (2)If any funds other than Federal appropriated funds (including profit or fee received under a <br /> covered Federal transaction) have been paid, or will be paid, to any person for influencing or <br /> attempting to influence an officer or employee of any agency,a Member of Congress, an officer <br /> or employee of Congress, or an employee of a Member of Congress on his or her behalf in <br /> connection with this solicitation, the offeror shall complete and submit,with its offer, OMB <br /> standard form LLL, Disclosure of Lobbying Activities,to the Contracting Officer;and <br /> (3)He or she will include the language of this certification in all subcontract awards at any tier and <br /> require that all recipients of subcontract awards in excess of$150,000 shall certify and disclose <br /> accordingly. <br /> (c)This certification is a material representation o.f fact upon which reliance is placed when this <br /> transaction was made or entered into. Submission of this certification and disclosure is a <br /> prerequisite for making or entering into this contract imposed by section 1352, title 31, United <br /> States Code. Any person making an expenditure prohibited under this provision or who fails to file <br /> or amend the disclosure form to be filed or amended by this provision, shall be subject to a civil <br /> penalty of not less than$10,000, and not more than $100,000,for each such failure. <br /> SIGNATURE. III -2d I r I I I II I I I I hi <br /> Matt Vernon, President <br /> COMPANY NAME: Kassel & Associates, Inc. <br /> DATE: January 31, 2017 <br /> WFP Operations Building Seismic Retrofit-Rebid January 6, 2017 <br /> WO#UP3600 004563 -2 <br /> Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scal <br />