Certification for Contracts,Grants, Loans, and Cooperative Agreements
The undersignedcertifies, to the best ofhis or her knowledge andbelief,that:
(1)NoFederalappropriatedfundshavebeenpaidorwillbepaid,byoronbehalfoftheundersigned,toanypersonforinfluencingorattemptingtoinfluenceanofficeroremployeeofanyagency,aMemberofCongress,anofficeroremployeeofCongress,oranemployeeofaMemberofCongressinconnectionwiththeawardingofanyFederalcontract,themakingofanyFederalgrant,themakingofanyFederalloan,theenteringintoofanycooperativeagreement,andtheextension,continuation,renewal,amendment,or modification of anyFederalcontract,grant,loan, or cooperative agreement.
(2)IfanyfundsotherthanFederalappropriatedfundshavebeenpaidorwillbepaidtoanypersonforinfluencingorattemptingtoinfluenceanofficeroremployeeofanyagency,aMemberofCongress,anofficeroremployeeofCongress,oranemployeeofaMemberofCongressinconnectionwiththisFederalcontract,grant,loan,orcooperativeagreement,theundersignedshallcompleteandsubmitStandardForm-LLL,“DisclosureForm to ReportLobbying,”in accordance with its instructions.
(3)Theundersignedshallrequirethatthelanguageofthiscertificationbeincludedintheawarddocumentsforallsubawardsatalltiers(includingsubcontracts,subgrants,andcontractsundergrants,loans,andcooperativeagreements)andthatallsubrecipientsshallcertifyanddisclose accordingly.
Thiscertificationisamaterialrepresentationoffactuponwhichreliancewasplacedwhenthistransactionwasmadeorenteredinto.Submissionofthiscertificationisaprerequisiteformakingorentering intothistransactionimposedbysection1352,title31,
U.S.Code.Anypersonwhofailstofiletherequiredcertificationshallbesubjecttoacivilpenaltyofnot lessthan $10,000 and not more than $100,000 for eachsuchfailure.
OrganizationName
Name of AuthorizedOfficial
SignatureDate
Certification forLoan Guarantees and Loan Insurance
The undersignedcertifies, to the best ofhis or her knowledge andbelief,that:
IfanyfundsotherthanFederalappropriatedfundshavebeenpaidorwillbepaidtoanypersonforinfluencingorattemptingtoinfluenceanofficeroremployeeofanyagency,aMemberofCongress,anofficeroremployeeofCongress,oranemployeeofaMemberofCongressinconnectionwiththiscommitmentprovidingfortheUnitedStatestoinsureorguaranteealoan,theundersignedshallcompleteandsubmitStandardForm-LLL,“Disclosure Form to ReportLobbying,”in accordance with its instructions.
Submissionofthiscertificationisaprerequisiteformakingorenteringintothistransactionimposedbysection1352,title31,U.S.Code.Anypersonwhofailstofiletherequiredcertificationshallbesubjecttoacivilpenaltyofnotlessthan$10,000andnotmore than $100,000 for eachsuchfailure.
OrganizationName
Name of AuthorizedOfficial
SignatureDate