1994 AGN SEP 06 I20 - Laserfiche WebLink

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Attachment A Certification for Contra is Grant!, t oanc and Cooperative 4nrPern ,.,•.. (Federal Fiscal Year October 1, 19,E to September 30, 19 I' ictn C. Iizttm hereby certify on behalf (Name and title of Grantee official) of City of Camm (Name of Grantee) - that (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned; to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making f an Federal grant, the making of any Federal loan, the entering into of any cooperative agreement,, y the extension, continuation, renewal, amendment, or modification of any Federal 6ntractent loan, or cooperative agreement. grant, (2) If any funds other than Federal appropriated funds have beerspaid or will an be aid to person for influencing or attempting to influence an officer or employee of any Federal a agency,, g a Member of Congress, an officer or employee of Congress, or an employee of a Member of y' in connection with this Federal contract, grant, loan, or cooperative agreement the undersignedIngress shall complete and submit Standard Form- accordance with its instructions.'' *Disclosure Form to Report Lobbying,' in (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, and contracts and subcontracts under grants, subgrants„ loans, and cooperative agreements) which exceed $100,000 , and all such subrecipients shall certify and disclose accordingly. that This certification is a material representation of fact upon which reliance was Placed when transaction was made or entered into. Submission of this certification is a prerequisite for this making or entering into this transaction imposed person who fails to file the required certification sha�1 be nu1352, title 31, U. S. Code. Any than $10,000 and not more than $100,000 for each such failure. to a civil penalty of not less Executed this 18 day of _AugMt 1994. By: C ignaturs of atthorized official) Dixec bcr cf Antic Wajm (Title of authorized official)