Common use of Certification Regarding Lobbying Clause in Contracts

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief that: a. 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 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 a federal contract, the making of a federal grant, the making of a federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement. b. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer 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 grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. c. The Contractor shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers and that all sub- recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor CONTRACTOR certifies that to the best of his or her its knowledge and belief that: a. A. No federal federally appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned CONTRACTOR to any person persons for influencing or attempting to influence an officer or an employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a federal loan, the entering into of a any federal cooperative agreement, and or the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, loan or cooperative agreement. b. B. If any funds other than federal federally appropriated funds have been paid or will be paid to any person persons for influencing or attempting to influence an officer or employee of any an agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant contract, grant, loan or cooperative agreement, the undersigned CONTRACTOR shall complete and submit Standard Form-LLLForm -111, "“Disclosure Form to Report Lobbying," ” in accordance with its the form’s instructions. c. The Contractor C. CONTRACTOR shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers tiers, (including subcontracts, subgrants, and contracts under grants, loans and cooperation agreements) and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. D. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsThe undersigned certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief belief, that: a. (1) No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal any Federal contract, the making of a federal grantany Federal Cooperative Agreement, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, amendment or modification of a federal any Federal contract, grant, loan, or cooperative agreement. b. (2) If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with this federal grant Federal contract, grant, loan, or cooperative agreement, the undersigned shall must complete and submit Standard Form-LLL, "“Disclosure Form to Report Lobbyingof Lobbying Activities," ” in accordance with its instructions. c. (3) The Contractor shall undersigned must require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all sub- recipients shall subrecipients must certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification shall will be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsThe Bidder or Offeror certifies by signing and submitting this bid or proposal, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief belief, that: a. (1) No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned Bidder or Offeror, to any person for influencing or attempting to influence an officer or employee of any an agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal any Federal contract, the making of a federal any Federal grant, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal any Federal contract, grant, loan, or cooperative agreement. b. (2) If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with this federal grant Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.Form- c. (3) The Contractor undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all sub- sub-recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State state entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief that: a. 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 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 a federal contract, the making of a federal grant, the making of a federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement. b. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer 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 grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. c. The Contractor shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers and that all sub- recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsGrants, sub-grantsSubgrants, cooperative agreementsCooperative Agreements, and contracts exceeding Contracts Exceeding $100,000 in federal fundsFederal Funds. 1. For agreements Agreements with contractors Contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered the California Health Benefit Exchange to perform services. By signing this Agreement, Agreement the Contractor certifies that to the best of his or her knowledge and belief belief, that: a. No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal Federal contract, the making of a federal Federal grant, the making of a federal Federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal Federal contract, grant, loan, or cooperative agreement. b. If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant Federal Grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," ", in accordance with its instructions. c. The Contractor shall require that the language of this certification be included in the award documents for all covered sub-awards subawards exceeding $100,000 in federal Federal funds at all appropriate tiers and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States U. S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsThe Contractor certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her its knowledge and belief belief, that: a. No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned it, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal any Federal contract, the making of a federal any Federal grant, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal any Federal contract, grant, loan, or cooperative agreement.; b. If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with this federal grant Federal contract, grant, loan, or cooperative agreement, the undersigned shall it will complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," (which is available on the HUD website or here: xxxxx://xxx.xxxxxxxxxxx.xxxx/resources/documents/HUD-Form-Sflll.pdf in accordance with its instructions.; and c. The Contractor shall It will require that the language of this certification Section be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subcontracts at all appropriate tiers and that all sub- recipients shall certify and disclose accordinglytiers. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. d. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State state entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief that: a. 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 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 a federal contract, the making of a federal grant, the making of a federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement. b. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer 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 grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. c. The Contractor shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers and that all sub- recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31Xxxxx 00, United States Xxxxxx Xxxxxx Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsGrants, sub-grantsSubgrants, cooperative agreementsCooperative Agreements, and contracts exceeding Contracts Exceeding $100,000 in federal fundsFederal Funds. 1. For agreements Agreements with contractors Contractors who are State CDSS entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California CDSS to perform services. By signing this Agreement, Agreement the Contractor certifies that to the best of his or her knowledge and belief belief, that: a. No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal Federal contract, the making of a federal Federal grant, the making of a federal Federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal Federal contract, grant, loan, or cooperative agreement. b. If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant Federal Grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," ", in accordance with its instructions. c. The Contractor shall require that the language of this certification be included in the award documents for all covered sub-awards subawards exceeding $100,000 in federal Federal funds at all appropriate tiers and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsThe undersigned certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief belief, that: a. (1) No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal contract, the making of a federal any Federal grant, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, amendment or modification of a federal any Federal contract, grant, loan, or cooperative agreement. b. (2) If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with this federal grant Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-Form- LLL, "Disclosure Form to Report Lobbyingof Lobbying Activities," in accordance with its instructions. c. (3) The Contractor undersigned shall require that the language of this certification be included in the award documents for of all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub- recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure. Organization: Street address: City, State, Zip: CERTIFIED BY:(type or print) TITLE: This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer 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 a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., “RFP-DE-90-001.” 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

Certification Regarding Lobbying. Applicable to grantsThe undersigned certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or his/her knowledge and belief belief, that: a. : No federal Federally appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congressthe Congress, or an employee of a member Member of congress the Congress in connection with the awarding of a federal any Federal contract, the making of a federal any Federal grant, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal any Federal contract, grant, loan, or cooperative agreement. b. . If any funds funds, other than federal Federal appropriated funds funds, have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressthe Congress, or an employee of a member Member of congress the Congress in connection with this federal grant Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. c. . The Contractor undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub- sub-recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S.C. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure. Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to children’s services that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children’s services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. Grant Compliance: Contractor shall comply with all KDADS requests for information for federal grant compliance including but not limited to Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards and the Federal Funding Accountability and Transparency Act (FFATA).

Certification Regarding Lobbying. Applicable to grantsThe Consultant, sub-grantscertifies, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her the Consultant's knowledge and belief that: a. No belief, that no federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned Consultant, to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a any federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement. b. . If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer 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 grant or agreementthe above-mentioned parties, the undersigned shall Sub-Recipient will complete and submit Standard Form-Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. c. . The Contractor shall Consultant will require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all sub- recipients shall subrecipients will certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall will be subject to a civil penalty of no not less than $10,000 10,000.00 and not more than $100,000 100,000.00 for each such failure. Xxxx Anti-Lobbying Amendment, 31 U.S.C. 1352, as amended by the Lobbying Disclosure Act of 1995, P.L. 104-65. Any Consultant who applies or bids for an award of $100,000.00 or more will file the certification required by 49 CFR Part 20, "New Restrictions on Lobbying," attached to this Agreement as Exhibit C. Each tier certifies to the tier above that it will not and has not used federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any federal contract, grant, or any other award covered by 31 U.S.C. 1352. Each tier will also disclose the name of any registrant under the Lobbying Disclosure Act of 1995 who has made lobbying contacts on its behalf with non-federal funds with respect to that federal contract, grant, or award covered by 31 U.S.C. 1352. Such disclosures are forwarded from tier to tier up to the recipient.

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor CONTRACTOR certifies that to the best of his or her its knowledge and belief that: a. A. No federal federally appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned CONTRACTOR to any person persons for influencing or attempting to influence an officer or an employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a federal loan, the entering into of a any federal cooperative agreement, and or the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, loan or cooperative agreement. b. B. If any funds other than federal federally appropriated funds have been paid or will be paid to any person persons for influencing or attempting to influence an officer or employee of any an agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant contract, grant, loan or cooperative agreement, the undersigned CONTRACTOR shall complete and submit Standard Form-LLLForm -111, "“Disclosure Form to Report Lobbying," ” in accordance with its the form’s instructions. c. The Contractor C. CONTRACTOR shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers tiers, (including subcontracts, subgrants, and contracts under grants, loans and cooperation agreements) and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. D. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.. Use a version of this section if you want to have the right to approve in advance any materials developed or distributed under the Agreement:

Certification Regarding Lobbying. Applicable to grantsGrants, sub-grantsSubgrants, cooperative agreementsCooperative Agreements, and contracts exceeding Grants Exceeding $100,000 in federal fundsFederal Funds. 1. For agreements Agreements with contractors Grantees who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California CDSS to perform services. By signing this Agreement, the Contractor Grantee certifies that to the best of his or her knowledge and belief belief, that: a. No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal contract, the making of a federal Federal grant, the making of a federal Federal grant, the making of a Federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contractFederal grant, grant, loan, or cooperative agreement. b. If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant Federal Grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," ", in accordance with its instructions. c. The Contractor Grantee shall require that the language of this certification be included in the award documents for all covered sub-awards subawards exceeding $100,000 in federal Federal funds at all appropriate tiers and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States U. S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor CONTRACTOR certifies that to the best of his or her its knowledge and belief that: a. No federal X. Xx federally appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned CONTRACTOR to any person persons for influencing or attempting to influence an officer or an employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a federal loan, the entering into of a any federal cooperative agreement, and or the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, loan or cooperative agreement. b. B. If any funds other than federal federally appropriated funds have been paid or will be paid to any person persons for influencing or attempting to influence an officer or employee of any an agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant contract, grant, loan or cooperative agreement, the undersigned CONTRACTOR shall complete and submit Standard Form-LLLForm -111, "“Disclosure Form to Report Lobbying," ” in accordance with its the form’s instructions. c. The Contractor C. CONTRACTOR shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers tiers, (including subcontracts, subgrants, and contracts under grants, loans and cooperation agreements) and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. D. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor GRANTEE certifies that to the best of his or her its knowledge and belief that: a. A. No federal federally appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned GRANTEE to any person persons for influencing or attempting to influence an officer or an employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a federal loan, the entering into of a any federal cooperative agreement, and or the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, loan or cooperative agreement. b. B. If any funds other than federal federally appropriated funds have been paid or will be paid to any person persons for influencing or attempting to influence an officer or employee of any an agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant contract, grant, loan or cooperative agreement, the undersigned GRANTEE shall complete and submit Standard Form-LLLForm -111, "“Disclosure Form to Report Lobbying," ” in accordance with its the form’s instructions. c. The Contractor C. GRANTEE shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers tiers, (including subcontracts, subgrants, and contracts under grants, loans and cooperation agreements) and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. D. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsContractor certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief belief, that: a. 1) No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal any Federal contract, the making of a any federal grant, the making of a any federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal any Federal contract, grant, loan, loan or cooperative agreement. b. 2) If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with this federal grant Federal contract, grant, land, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "“Disclosure Form to Report Lobbying," ” in accordance with its instructions. c. 3) The Contractor undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.. By: Date: (Signature of Official Authorized to Sign Contract) 2/10/2014 Senior Services (Name of Grantee) Shoppiing & Errand Services (Title of Grant Program)

Certification Regarding Lobbying. Applicable This section is applicable to grants, sub-grantssubgrants, cooperative agreements, and contracts exceeding $100,000 in federal Federal funds. 1. For agreements with contractors Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who are State entities fails to file the required certification shall be subject to a civil penalty of not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of less than $10,000 and not more than $100,000 in federal funds from Covered California to perform servicesfor each. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief that: a. No federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with the awarding of a federal contract, the making of a federal grant, the making of a federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement. b. . If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "“Disclosure Form to Report Lobbying," ”, in accordance with its instructions. c. . The Contractor shall require that the language of this certification will be included in the award documents for all covered sub-sub awards exceeding $100,000 in federal funds at all appropriate tiers and that all sub- sub recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief that: a. a) No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned SUBRECIPIENT, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal any Federal contract, the making of a federal any Federal grant, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal any Federal contract, grant, loan, or cooperative agreement. b. b) If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting intending to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with this federal grant Federal contract, grant, loan, or cooperative agreement, the undersigned SUBRECIPIENT shall complete and submit Standard Form-LLLForm -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructionsto the CPH-SPF. c. c) The Contractor SUBRECIPIENT shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than that $10,000 and not more than that $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsGrants, sub-grantsSubgrants, cooperative agreements, Cooperative Agreements and contracts exceeding Contracts Exceeding $100,000 in federal fundsFederal Funds. 1. a. For agreements Agreements with contractors Contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California the Exchange to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief belief, that: a. i. No federal Federal appropriated funds have been paid or will shall be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal Federal contract, the making of a federal Federal grant, the making of a federal Federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal Federal contract, grant, loan, or cooperative agreement. b. ii. If any funds other than federal Federal appropriated funds have been paid or will shall be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant Federal Grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," ", in accordance with its instructions. c. The iii. Contractor shall require that the language of this certification be included in the award documents for all covered sub-awards subawards exceeding $100,000 in federal Federal funds at all appropriate tiers and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. b. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsThe Subcontractor certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her their knowledge and belief belief, that: a. (a) No federal appropriated funds have been paid or will be paid by or on behalf of the undersigned Subcontractor to any person for influencing or attempting to influence an officer or employee of any federal agency, a member of congressthe Congress, an officer or employee of congressthe Congress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a any federal loan, the entering into of a any cooperative agreement, and or the extension, continuation, renewal, amendment, or modification of a any federal contract, grant, grant loan, or cooperative agreement. b. (b) If any funds other than federal appropriated funds have been paid or will be paid 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 congressthe Congress, or an employee of a member of congress Congress in connection with this federal grant the Program Contract, grant, loan, or cooperative agreement, the undersigned applicant shall complete and submit Standard Form-LLL, "“Disclosure Form to Report Lobbying," ” in accordance with its instructions. c. The Contractor (c) Subcontractor shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub- sub-recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S.C.A. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 10,000.00 and not more than $100,000 100,000.00 for each such failure.

Certification Regarding Lobbying. Applicable to grantsThe GRANTEE certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her the GRANTEE’S knowledge and belief belief, that: a. : No federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned GRANTEE, to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a any federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement. b. . If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer 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 grant or agreementthe above mentioned parties, the undersigned shall GRANTEE will complete and submit Standard Form-Form LLL, "“Disclosure Form to Report Lobbying," ” in accordance with its instructions. c. . The Contractor shall GRANTEE will require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers (including subcontracts, subgrants, and that contracts under grants, loans, and cooperative agreements) and require all sub- recipients shall subrecipients to certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall will be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure. Xxxx Anti-Lobbying Amendment, 31 U.S.C. 1352, as amended by the Lobbying Disclosure Act of 1995, P.L. 104-65. Any GRANTEE who applies or bids for an award of $100,000 or more will file the certification required by 49 CFR Part 20, “New Restrictions on Lobbying,” attached to this Agreement as Exhibit F. Each tier certifies to the tier above that it will not and has not used federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any federal contract, grant, or any other award covered by 31 U.S.C. 1352. Each tier will also disclose the name of any registrant under the Lobbying Disclosure Act of 1995 who has made lobbying contacts on its behalf with non-federal funds with respect to that federal contract, grant, or award covered by 31 U.S.C. 1352. Such disclosures are forwarded from tier to tier up to the recipient.

Certification Regarding Lobbying. Applicable to grantsCertification for Contracts, sub-grantsGrants, cooperative agreementsLoans, and contracts exceeding $100,000 in federal funds.Cooperative Agreements (1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief that: a. ) No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with the awarding of a federal contractany Federal Contract, the making of a federal any Federal grant, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contractany Federal Contract, grant, loan, or cooperative agreement. b. (2) If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress in connection with this federal grant Federal Contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. c. (3) The Contractor undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds subawards at all appropriate tiers (including Subcontracts, subgrants, and Contracts under grants, loans and cooperative agreements) and that all sub- recipients subrecipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.. (Signature of Official Authorized to Sign Application) (Date) (Print Name) (Title) (Agency / Contractor Name) (Title of Program)

Certification Regarding Lobbying. (7 CFR 3018) (Applicable to grants, sub-grants, cooperative agreements, and contracts exceeding if this agreement exceeds $100,000 in federal funds.100,000) (1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief that: a. ) No federal Federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned sponsors, to any person for influencing or attempting to influence an officer or employee of any an agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee a Member of a member of congress Congress in connection with the awarding of a federal any Federal contract, the making of a federal any Federal grant, the making of a federal any Federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal any Federal contract, grant, loan, or cooperative agreement. b. (2) If any funds other than federal Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member Member of congressCongress, an officer or employee of congressCongress, or an employee of a member Member of congress Congress, in connection with this federal grant Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-Form - LLL, "“Disclosure Form to Report Lobbying," ” in accordance with its instructions. c. (3) The Contractor sponsors shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers (including sub-contracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub- sub-recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure.

Certification Regarding Lobbying. Applicable to grantsThe undersigned certifies, sub-grants, cooperative agreements, and contracts exceeding $100,000 in federal funds. 1. For agreements with contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from Covered California to perform services. By signing this Agreement, the Contractor certifies that to the best of his or her knowledge and belief thatbelief, that the following are true: a. 1. No federal appropriated funds have been paid or will be paid paid, by or on behalf of the undersigned undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congress, or an employee of a member of congress Congress in connection with the awarding of a any federal contract, the making of a any federal grant, the making of a any federal loan, the entering into of a any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a any federal contract, grant, loan, or cooperative agreement. b. . If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congressCongress, an officer or employee of congressCongress, or an employee of a member of congress Congress in connection with this federal grant contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "“Disclosure Form to Report Lobbying," ”, in accordance with its instructions. c. . The Contractor undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in federal funds at all appropriate tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements), and that all sub- sub-recipients shall certify and disclose accordingly. 2. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, United States Code. This certification is a material representation of fact upon which reliance was is placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of no not less than $10,000 and not more than $100,000 for each such failure. Executed this day of , 20 . Company Nam e: By: (Signature of Company Official) (Title of Company Official) Note: If Joint Venture, each Joint Venture member shall provide the above information and sign the certification.