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; _.r <br /> •= ` "Exhib�t <br /> CERTIFZCATION <br /> . OF <br /> \ RESTRZCTZONS ON I,OBBYING <br /> I , , hereby <br /> (Na^�e and Title o� Vencor or Contractor Official) <br /> certify on behalf of that: <br /> (Nz.�e of Vendor or Contractor) <br /> (I) No Federal appropriat�d funds have been paid oz Will be � <br /> paid, by or on behalf oz the undersigned, to any person for <br /> influencing or attempting to influence an officer or employee of <br /> ar.y agency, a Member of Congress, an officer or employee of <br /> �ongress , or an employee of a Member of. Congress in connection <br /> with the awarding of any Federal contract, the making of any • <br /> Federal grant, the making of any Federal loan, the entering into <br /> • of any cooperative agre�ment, and the extension, continuation, <br /> renewal, a�endment, oz mocification of any Federal centract, <br /> azant, loan, or coopezative agreement. <br /> (2) If any funds other than Federa2 appropriat�d funds have been <br /> paid or will be paid to any person for influencing az attempting <br /> to influence an officer oz employee of any agency, a Me:aber of <br /> Congress , an officer or er:.ployee of Congress, or an e.*nployep of a <br /> Member of Congress in connection with this Fe3eral contract, <br /> crant, Ioa:�, er cooperative agree:nent, the undersigned shall � <br /> complete and submit Standard For•n-LLL, "Disclosure Form to Report <br /> _ Lobbying, " in accordance w�th its instructions. <br /> _ t3) The undersicned shall se�uire that the Ianguage of this <br /> certification be includec ir. the award documents for aIl sub- <br /> a�ards at all tiers (Inclu�ing subcontracts, subgrants, and • <br /> contracts un�er grants, loar.s, and cooperative agreements? and <br /> that all subrecipients shall ce:tify anc disclose accordingly. <br /> This certiFication is a material zepzesentation of fact upon <br /> which zeliance is place� �::�en this transaction Was made or <br /> entered into. Submission of this certification is a prerequisite <br /> for makir.c or entering into this transaction imposed by section <br /> 1352 , title 31 , U. S . Co�e. Any person who fails to file the <br /> recuired certification sha�l be subject to a civil penalty of not <br /> Iess thar. �10 ,000 and not more than #200,000 foz each such <br /> failuze. <br /> Executed this �ay of , 19 <br /> Bv <br /> . {Signature of Authorized Official ) <br /> (Tit e o Aut orizea Officia ' <br />