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9828 00131-4 DEBARMENT AND SUSPENSION CERTIFICATION (LOWER TIER COVERED TRANSACTION) (To be submitted with a bid or Offer exceeding the small purchase threshold for Federal assistance Programs, currently $100,000.) The prospective lower tier participant (Offeror) certifies, by submission of this Offer, that neither R nor its 'prinGpals' as defined at 49 C.F.R. § 29.105(p) is presenlly debarred, suspended, proposed for debarr~ent, deGared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. If the prospective lower tier participant (Offeror) is unable to certify to the statement above, it shall attach an explanation, and indicate that it has done so, by placing an 'X' in the Following space THE BIDDER OR OFFEROR, t~~ ~~ ~~'n5~~ ~Jw«oc~ s ~ ACCURACY OF EACH STATEMENT OF ITS C RT F CATIONFAND EXpLpIVqTIONU F ANY.4NN ADDITION, THE BIDDER OR OFFEROR UNDERSTANDS AND AGREES THAT THE PROVISIONS OF 31 U.S.C §§ 3801 ET SEQ. APPLY TO THIS CERTIFICATION AND EXpLpNATION, IF ANY. Signature of the Bidder or Offeror's Authorized Official ~~~ Name and Title of the Bidder or Offeror's Authorized Official V ~ c..e, resi d ~t - '~ - y - ~ 4 Date LOBBYING CERTIFICATION (fo be submitted with a bid or Offer exceeding $100,000.) The Bidder or Offeror certifies, to the best its knowledge and belief, ihat: ~. 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 a Federal department or agency, a Member of the U.S. Congress, an oncer or employee of lhe U.S. Congress, or an employee of a Member of the U.S. Congress in connection with the awarding of any Federal contracc, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification thereof. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for making lobbying contaGs to an o~cer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Fortn - LLL, 'Dlsclosure Fortn to Report Lobbying; in accortiance with its instruction, as amended by 'Govemment Wide Guidance for New Restrictions on Lobbying,' 61 Fed. Reg. 1413 (1/19/96) 3. The undersigned shall require that the language of this certificatlon be included in the award documents for all subawards at all tiers Qncluding subcontracts, subgrants, and contracts undergrants, loans, and cooperative agreements) and that all subrecipients shall ceAify and disclose accordingly. This certificatfon is a material represerrtatlon of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.