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• "Exhibit E" <br /> - � � � CERTIFICATION <br /> OF <br /> RESTRICTIONS ON LOBBYING <br /> I, � - , hereby <br /> ame and Title of Vendot or Co tractor Official) <br /> � <br /> certify on behalf of ��� Qc,�,�c.ce�- that: <br /> Name of ndo Contractor <br /> , • . <br /> (1) No Federal �ppropriated funds have been paid or will be <br /> paid, by or on behalf of the undersfgned, to any person for <br /> influencing or attempting to fnfluence an officer or employee of <br /> any egency, a Member of Conqress, an officer or employee of <br /> Congress, or an employee of a Hember of. Congress in connection <br /> with the awarding of any Federal contract, the making of any • <br /> Federal grant, the makinq of any Federal loan, the entering into <br /> of any cooperative agreement, and the extension, continuation, <br /> tenewal, amendment, or moc3ification of any Federal contract, <br /> grant, loan, or cooperative agreement. <br /> (2) If any funds other than Fec]eral appropriated fun8s have been <br /> paid or will be paid to any person for influencing or attempting <br /> to influence an officer or employee of any agency, a Member of <br /> Congress, s.n officer or employee of Congress, or an employee of e <br /> Member of Congress in connection With this Federal contzact, <br /> grant, loan, or cooperative agreement, the unc�ersigned shall <br /> complete and 6ubmit Standard Form-I.LL, "Disclosure Form to Report <br /> Lobbying," in accorc7ance With its instructions. , <br /> (3) The undersignecl shall require that the lanquage of this <br /> certificatfon be included in the award documents for ell sub- <br /> award s at all tiers (Including subcontracts, subgrants, an8 � <br /> contracts under grants, loans, and cooperative egreements) and <br /> that ell subrecipients shall certify and disclose accordingly. <br /> This certification is a material representation of f�ct upon <br /> which reliance is placed When this transaction was made or <br /> entered into. Submission of this certification is a prerequisite <br /> for making or entering into this transactfon imposed by section <br /> 1352, title 31 , U. S. Code. Any person who fails to file the <br /> required certification shall be 6ubject to a civil penalty of not <br /> less than =10,000 and not moze than ;100,000 for each such <br /> failure. , . <br /> Executed this _� day of , 19�. <br /> . By ' <br /> . Sig re o Aut or ze Offic al) <br /> . �a-.ti-�`-�. � <br /> �T1t�O�A�IIOZ�Ze� O�1C1�- ' <br />