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F <br /> 1 <br /> . - renewal, amendmen#, or modification of an federal contract rant la <br /> . Y , g an, or cooperative <br /> agreemen#. <br /> 1 <br /> B. if any funds .other than federal a ro rioted funds have b ' <br /> pp p een paid or wil! be paid to any <br /> person for influencing or attempting to influence an officer or employee of an federal <br /> Y <br /> agency, a Member of Congress, an officer or employee, of Congress, or an em to ee of <br /> pY <br /> a Member of Congress in connection with this federal contract rant loan or <br /> c s ~ g ~ y <br /> ooperative agreement, the undersigned shall complete and submit Standard Form-LLL <br /> "Disclosure Form to Re ort Lobb in " in accordance with its instr ' <br /> . uctions. <br /> C.~ The undersigned shat! re wire that the Ian ua e <br /> q g g of this certification be included in the <br /> award documents for <br /> all subawards at all tiers including subgrants, and contracts and <br /> subcontracts under grants, subgrants, loans, and cooperative a reernents which <br /> g ~ <br /> exceed $104,000, and that all such subrecipients shall certify and disclose accordin I . <br /> gY <br /> D. -This certification is a material representation of fact upon which reliance was laced <br /> p <br /> when this transaction was made or entered into. Submission of this certification is a <br /> prerequisite far making or enterin into this transaction im osed <br /> . g p by Title 3~, USG 5ect~on <br /> ~~irr <br /> E <br /> E. Any person who fails to file the required certifcation shall be subject to a civil enal of <br /> p tY <br /> not less than $14,040 and not more than $1 X4,040 for each such failure. <br /> I <br /> f <br /> • i <br /> Paragraphs 35, 36, and 47 are not applicable to any local agency on state hi hwa ro'ects. <br /> g Yp I <br /> I <br /> 1 <br /> k <br /> j <br /> ii <br /> E <br /> I <br /> i <br /> i <br /> <br /> - STDPR4-2oU6.doc ~ <br /> Rcv. 7-3-206 . <br /> . <br /> . <br /> . . <br /> <br />