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ATTACHMENT A
<br />CERTIFICATION REGARDING LOBBYING
<br />(To be submitted wf, h�a bids or offers exceeding $100,000; must be executed prior to Award)
<br />The undersigned r "" certifies, to the best of his or her knowledge and belief, that:
<br />(Contractor)
<br />I. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
<br />persons for influencing or attempting to influence an officer or employee of any agency, a Member of
<br />Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection
<br />with the awarding to any Federal contract, the making of any Federal grant, the making of any Federal
<br />loan, the entering into of any cooperative agreement, and the extension, continuation, renewal,
<br />amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
<br />2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for
<br />influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
<br />officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal
<br />contract, grant loan, or cooperative agreement, the undersigned shall complete and submit Standard
<br />Form -LLL, "Disclosure Form to Report Lobbying ", in accordance with its instructions [as amended by
<br />"Government wide Guidance for New Restrictions on Lobbying," 61 Fed. Reg. 1413 (1119/96). Note:
<br />language in paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying
<br />Disclosure Act of 1995 (P.L. 104 -65, to be codified at 2 U.S.C. 1601, et seq .)]
<br />3. The undersigned shall require that the language of this certification be included in the award documents
<br />for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
<br />cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
<br />This certification is a material representation of fact upon which reliance is placed when this transaction
<br />was made or entered into. Submission of this certification is a prerequisite for making or entering into this
<br />transactions imposed by 31, U.S.C. 1352 (as amended by the Lobbying Disclosure Act of 1995). Any
<br />person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000
<br />and not more than $100,000 for each such failure,
<br />[Note: Pursuant to 31 U.S.C. 1352(c)(1)- (2)(A), any person who makes a prohibited expenditure or fails to file
<br />or amend a required certification or disclosure form shall be subject to a civil penalty of not less than $10,000
<br />for each such expenditure or failure.]
<br />The Contractor, 6wak AYtvd]? tti!C certifies or affirms the truthfulness and accuracy of each statement
<br />of its certification and disclosure, if any. In addition, th o ?'or under nds and agrees that the provisions
<br />of ection A 3801 et seq., apply to this ce ti d di c s e, if any. IT4
<br />Date Sig at r f Co tra Authorized ?fficiay
<br />Name and Title of Contra ors A6thorized Official
<br />Subscribed and sworn to before me this N day of Apfi 20$, in the State of 1 v
<br />and the County of MkKkA4epl- 7—
<br />Notary Public
<br />My Appointment Expires WnV — aD9�
<br />a
<br />HETAL SETHII
<br />Notary Public
<br />Mecklenburg Co., North Carolina 46
<br />My Commission Expires Nov. 07, 2018
<br />Attachment number 1
<br />F -4 Page 91
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