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DocuSign Envelope ID: 348BB866-CFC7-422D-BFB7-863533B13759
<br />Attachment B
<br />GLO Contract No. 22-119-004-D374
<br />Page 3 of 5
<br />CERTIFICATION REGARDING LOBBYING
<br />COMPLIANT WITH APPENDIX A TO 24 C.F.R. PART 871
<br />Certification for Contracts, Grants, Loans, and Cooperative Agreements:
<br />The undersigned certifies, to the best of his or her knowledge and belief, that:
<br />(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person
<br />for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or
<br />employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal
<br />contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative
<br />agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant,
<br />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 influencing or
<br />attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
<br />Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or
<br />cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to
<br />Report Lobbying," in accordance with its instructions.
<br />(3) The undersigned shall require that the language of this certification be included in the award documents for all
<br />subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative
<br />agreements) and that all subrecipients shall certify and disclose accordingly.
<br />This certification is a material representation of fact upon which reliance was placed when this transaction was made
<br />or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
<br />by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
<br />penalty of not less than $10,000 and not more than $100,000 for each such failure.
<br />Statement for Loan Guarantees and Loan Insurance:
<br />The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be
<br />paid to any person 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 with this
<br />commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and
<br />submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
<br />Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352,
<br />title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less
<br />than $10,000 and not more than $100,000 for each such failure.
<br />As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the
<br />above applicable certification.
<br />NAME OF APPLICANT AWARD NUMBER AND/OR PROJECT NAME
<br />City of La Porte 22-119-004-13374
<br />PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
<br />Louis Rigby Mayor
<br />SIGNATURE•—'--opcuSigued by: DATE
<br />thw,$ 44 3/21/2022
<br />1 24 C.F.R. 87 App. A, available at https://www.gl2o.gov/fdsys/granule/CFR-2011-title24-voll/CFR-2011-title24-voll-part87-
<br />IMAA. Published Apr. 1, 2011. Accessed Aug. 1, 2018.
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