|
A. The prospective participant certifies, by signing and submitting this bid or proposal, to
<br /> the best of his or her knowledge and belief, that:
<br /> (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of
<br /> the undersigned, to any person for influencing or attempting to influence an
<br /> officer or 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 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
<br /> -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
<br /> to any person for influencing or attempting to influence an officer or employee of
<br /> any Federal agency, a. Member of Congress, an officer or employee of Congress,
<br /> or an employee of a Member of Congress in connection with this Federal
<br /> contract, grant, loan, or cooperative agreement, the undersigned shall complete
<br /> and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
<br /> accordance with its instructions.
<br /> B. This certification is a material representation of fact upon which reliance was placed
<br /> when this transaction was made or entered into. Submission of this certification is a
<br /> prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any
<br /> 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 /> C. The prospective participant also agrees by submitting his or her bid or proposal the he or
<br /> she shall require that the language of this certification be included in all lower tier
<br /> subcontracts, which exceed $100,000 and that all such recipients shall certify and
<br /> disclose accordingly.
<br /> 22. Any person who believes that he/she has been excluded from participation in, denied
<br /> benefits or services of any program or activity administered by the Department or its sub-
<br /> recipients, consultants, and contractors on the basis of age, disability, gender, race, color,
<br /> national origin, age income status and religion may bring forth a complaint of discrimination
<br /> under Title VI and related statutes to the Oregon Department of Transportation, Office of
<br /> Civil Rights, 800 Airport Road SE, Salem, Oregon, 97301, (503)986-4350.
<br /> Personal Services Contract (Architect and Engineer)--Page 6
<br />
<br /> (Revised December 1997)
<br />
<br />
|