Form RD1940-Q Exhibit A RD1940-Q Exhibit A Certification for Contracts, Grants and Loans Regarding

RD Instruction 1940-Q
Exhibit A-1

CERTIFICATION FOR CONTRACTS, GRANTS AND LOANS
The undersigned certifies, to the best of his or her knowledge and belief,
that:
1.
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 any Federal contract, the making of any
Federal grant or Federal loan, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant or loan.
2.
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 contract, grant or loan, the undersigned shall complete and
submit Standard Form - LLL, "Disclosure of Lobbying Activities," in accordance
with its instructions.
3.
The undersigned shall require that the language of this certification
be included in the award documents for all subawards at all tiers (including
contracts, subcontracts, and subgrants under grants and loans) and that all
subrecipients shall certify and disclose accordingly.
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 not less than $10,000 and not more than $100,000 for each such failure.

______________________________________
(name)

_________________________________
(date)

______________________________________
(title)

oOo

(08-21-91)

PN 171