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GJN3923 Revenue Folder
COE
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2008
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GJN3923 Revenue Folder
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Entry Properties
Last modified
11/8/2011 4:31:11 PM
Creation date
12/30/2008 11:29:01 AM
Metadata
Fields
Template:
PW_Capital
PW_Document_Type_Capital
Admin Documents
PW_Active
No
External_View
No
GJN
003923
GL_Project_Number
935034
Identification_Number
Key #13404
COE_Contract_Number
2006-00222
GL_Grant
381
Retention_Destruction_Date
6/20/2021
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A. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, <br /> to any person for influencing or attempting to influence an officer or employee of any federal <br /> agency, a Member of Congress, an officer or employee of Congress, or an employee of a <br /> Member of Congress 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 cooperative agreement, and <br /> the extension, .continuation, renewal, amendment, or modification of any federal contract, grant, <br /> loan, or cooperative agreement. <br /> B. If any funds other than federal appropriated funds have been paid or will be paid to any person <br /> for influencing or attempting to influence an officer or employee of any federal agency, a <br /> Member of Congress, an officer or employee of Congress, or an employee of a Member of <br /> Congress in connection -with this federal contract, grant, loan, or cooperative agreement, the <br /> undersigned shall complete and submit Standard Form-LLL. "Disclosure Form to Report <br /> Lobb, <br /> i~~,„ in accordance with its instructions. <br /> C. The undersigned shall require that the language of this certification be included in the award <br /> documents for all subawards at all tiers (including subgrants, and contracts and subcontracts <br /> under grants, subgrants, loans, and cooperative agreements) which exceed $100,000, and that all <br /> such subrecipients shall certify and disclose accordingly. <br /> <br /> _ D. This certification is a material representation of fact upon which reliance was placed when this <br /> transaction was made or entered into. Submission of this .certification is a prerequisite for <br /> making or entering into this transaction imposed by Title 31, USC Section 1352. <br /> E. Any person who fails to file the required certification shall be subject to a civil penalty of not <br /> less than $10,000 and not more than $100,000 for each such failure. <br /> Paragraphs 35, 36, and 47 are not applicable to any local agency on state highway projects. <br /> STDPRO-2005.doc 9 <br /> Rev. 3-22-OS <br /> <br />
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