Woody Biomass Removal and Hauling Services

REQUEST FOR PROPOSAL (RFP)
RFP #P26-15
Woody Biomass Removal and Hauling Services
RFP SUMMARY:
To enter into an agreement with one (1) or more Contractor(s) to perform woody biomass removal,
reduction and hauling services, to help deal with the woody biomass generated from forestry,
wildfire mitigation and hazardous fuels treatments.
This RFP is Federally Funded.
Vendors are encouraged to review Exhibit D in the sample agreement which is published with this
RFP as Attachment A - Professional Services Agreement. Exhibit D will be part of the agreement.
QUESTION DEADLINE: September 4, 2026 @ 10:00 a.m. (MT)
All questions regarding this solicitation must be emailed to the Contact Person identified below. If you do not
receive a confirmation email of receipt, please call the Contact Person to verify receipt of your questions. No
questions will be accepted after the date and time referenced above. All questions received will be answered
via Addendum only.
PRE-PROPOSAL MEETING: August 28, 2026 @ 1:00 PM (MT)
Vendors are requested (not required) to attend a virtual Zoom Meeting conference. Vendors should read the
entire RFP document prior to the Pre-Proposal Meeting.
TO ATTEND THE VIRTUAL PRE-PROPOSAL MEETING:
https://larimer-org.zoom.us/j/91222792238?pwd=36PDL6buLFVTSIzE2d1Wtjsion2maA.1
Meeting ID: 912 2279 2238
Passcode: 762906
DEADLINE FOR SUBMITTALS: September 18, 2026 @ 2:00 p.m. (MT)
The Board of Larimer County Commissioners will only be accepting proposals electronically submitted via the
Rocky Mountain E-Purchasing System (BidNet, BidNet Direct) portal, up to the date and time referenced
above, at which time they will be recorded, but not publicly opened on behalf of the Office of Emergency
Management Department.
BIDNET PORTAL / RFP OFFICIAL WEBSITE:
To submit your proposal and view official solicitation documents and addenda only available on the BidNet
portal, use the following link: https://www.bidnetdirect.com/colorado/larimer-county/
CONTACT PERSON:
Purchasing Agent Les Brown, brownxld@co.larimer.co.us, 970-498-5954
NOTE: Unauthorized contact with a County employee other than the Contact Person listed above or
Purchasing Manager regarding this RFP may result in disqualification of your Proposal.
Page 1 of 11

1. GENERAL INSTRUCTIONS FOR PROPOSERS:
1.1 Artificial Intelligence (AI) Disclosure:
Portions of this solicitation may have been prepared or modified with the assistance of Artificial Intelligence (AI)
technologies. All such content has been reviewed, verified, and approved for accuracy and compliance by the
Purchasing Agent prior to issuance.
1.2 Cooperative Use
Other governmental entities may piggyback on the award of this solicitation, assuming the award vendor is
amenable, and should contact Larimer County Purchasing for any necessary procurement documents. The
entity will deal directly with the award vendor concerning the placement of Purchase Orders, freight charges,
contracting and disputes, invoicing, and payment. Larimer County will not be held liable or responsible for any
liability, claims, costs, damages, demands, actions, losses, judgments or expenses incurred by the vendor or
any government entity relating to such use.
1.3 Equal Opportunity Employer (EEO) / Disadvantaged Business Opportunities:
Larimer County, in accordance with Federal and State laws, is an Equal Opportunity Employer and does not
discriminate. Larimer County strongly encourages the use of small and minority firms, women's business
enterprises, and labor surplus area firm services.
Larimer County hereby notifies all Proposers they will be afforded full and fair opportunity to submit a Proposal
in response to this RFP and they will not be discriminated against on the basis of age 40 and over, race, sex
(including pregnancy), color, religion, national origin, disability, genetic information, sexual orientation, gender
identity, gender expression, military or veteran status, or any other applicable status protected by Federal,
State, or local law in consideration for award.
1.4 Payment:
Payment for work performed or goods sold to Larimer County can be expected within 30 days after receipt of
the invoice and satisfactory acceptance by the Department receiving the service or goods (unless otherwise
stated and agreed to by County).
1.5 Proposal Consideration:
Larimer County reserves the right to reject any and or all proposals, to further negotiate with any and/or all
qualified proposers and to waive informalities and irregularities in proposals received, and to accept any
portion of the proposal if deemed to be in the best interest of Larimer County to do so. If, in the sole judgment
of the Board of County Commissioners, the proposals are substantially equal, the Board may grant the contract
to companies located in Larimer County, however this is not applicable in the case that Federal funds are
used.
1.6 Proposal Preparation:
Proposers will not be compensated for generating, producing, or duplicating any proposal materials associated
with this RFP. Proposals must be furnished exclusive of any Federal, State, or Local taxes; Larimer County is
tax exempt.
1.7 Proposal Submission:
Proposers must be registered with BidNet in order to submit a proposal; registration is free. Larimer County
strongly recommends proposers register well in advance of the submittal deadline to ensure they have
adequate time to upload and submit their proposal.
It is the sole responsibility of the Proposer to ensure all required Proposal documents are submitted through
BidNet by the submission deadline. Proposals will be time-stamped by BidNet upon receipt; BidNet does not
allow for uploading or submitting Proposal documents after the Proposal submittals deadline has passed, so
allow adequate time to upload and submit your Proposal prior to the deadline. Larimer County will not accept
Page 2 of 11

uploads that are "saved" but not "submitted". To verify that a Proposal has been submitted successfully,
Proposers may contact BidNet Support, or verify, via the Proposal Management tab in the Proposer's account,
that the documents are not in "Draft" status.
Proposers are required to submit one (1) non-redacted proposal. All parts of the proposal should be
combined and submitted as one (1) single .pdf file; proposals comprised of multiple separate files are
not acceptable and your proposal may be rejected.
By submitting a proposal, the proposer agrees they may not rescind their proposal on or after the closing date
and time identified in the RFP or as modified by addendum. No delivery will become due or be accepted until
an agreement has been completed either in the form of a formal executed contract, or a purchase order issued
by the Purchasing Manager of Larimer County. Prices and terms will remain in effect until a contract has
been executed.
1.8 Public Records:
Proposers may choose to also provide one (1) redacted .pdf proposal (as one single file), excluding any
information that is not subject to disclosure under the Colorado Open Records Act ("CORA"), such as trade
secrets, privileged information and confidential commercial, financial, geological or geophysical data exempt
from public disclosure under C.R.S. 24-72-204(3)(a)(IV). Statements that the entire proposal is confidential
will not be honored. After the Notice of Award has been issued, all information submitted in response to this
request for proposal (RFP) may be publicly disclosed if required under the CORA. If provided, the redacted
electronic copy will be used to satisfy CORA requests. Proposers that do not provide a redacted electronic
copy will have their non-redacted electronic copy used to satisfy CORA requests. Larimer County will
endeavor to keep the non-redacted proposal, separate and apart from the redacted proposal subject to the
provisions of CORA or Order of Court.
1.9 Reasonable Accommodations:
Per the Americans with Disabilities Act (ADA), Larimer County will provide reasonable accommodation to
qualified individuals with a disability who need assistance. Services can be arranged with at least seven (7)
business days' notice. Please email the Contact Person listed on the page 1 or call Relay Colorado
711. "Walk-in" requests for auxiliary aids and services will be honored to the extent possible but may be
unavailable if advance notice is not provided.
1.10 Regulatory and Legal Compliance Requirements:
No vendor awarded a solicitation will be federally debarred. Such debarment will be checked through the
System for Award Management, at www.sam.gov.
All businesses, organizations, and individuals contracting with Larimer County must comply with Title II of the
Americans with Disabilities Act of 1990, as amended. For more information on these requirements and to read
the full Title II text, please go to the following web page: https://www.ada.gov/ada_title_II.htm.
Domestic Preferences (2 CFR 200.322)
When federal funds are used, Larimer County to the greatest extent practicable and consistent with law, may
provide preference for the purchase, acquisition, or use goods, products, and materials produced in the United
States. This includes, but is not limited to, iron, aluminum, steel, cement, and other manufactured
products. The requirements of 2 CFR 200 must be included in all subawards, contracts, and purchase orders
under Federal awards.
For projects involving infrastructure-whether or not infrastructure is the primary purpose-the stricter of the
Domestic Preference or Buy America requirements will apply (see below).
Page 3 of 11

Buy America Preferences for Infrastructure Projects (2 CFR 184):
When federal funds are used;
* All iron or steel articles, materials, or supplies must be produced entirely in the U.S. (from initial melting
through coatings).
* All manufactured products must be produced in the U.S., with more than 55% of total component costs
coming from U.S. sources.
* All construction materials (non-ferrous metals, plastic and polymer products, glass, fiber optic cable
(including drop cable), optical fiber, lumber, drywall, engineered wood) must be manufactured in the
U.S.
* Cement, aggregates (sand, gravel, stone), and aggregate binding agents are excluded and not subject
to Buy America.
Recovered Materials Requirement (2 CFR 200.323):
Larimer County and its contractors must comply with Section 6002 of the Solid Waste Disposal Act (as
amended by the Resource Conservation and Recovery Act). This requires purchasing EPA-designated items
(40 CFR Part 247) that contain the highest practicable percentage of recovered materials, consistent with
satisfactory competition. This applies when the item's purchase price exceeds $10,000 or when County
purchases of that item exceeded $10,000 in the previous fiscal year. Covered categories include paper
products, vehicular products, construction and transportation products, park and recreation products,
landscaping products, non-paper office products, and miscellaneous products.
The Proposer certifies that by submitting an offer, neither the contractor nor subcontractors, the organization
nor its principals are suspended or debarred or otherwise excluded from procurement by the Federal
government and do not appear on the Excluded Parties List System (EPLS) maintained by the General
Services Administration (GSA).
2. PROJECT OVERVIEW:
Larimer County ("County") intends to enter into an agreement with one (1) or more Contractor(s) to perform
woody biomass removal, reduction, and hauling services on woody biomass generated from forestry, wildfire
mitigation, and hazardous fuels treatments throughout Larimer County. The County has a number of treatment
activities planned over the next 4-5 years as a part of Federally-Funded grants.
"Woody biomass" is defined as the by-product of forest wildfire mitigation and hazardous fuels
treatments and may be in the form of logs of varying diameters, root balls, and/or residual slash (i.e. limbs,
smaller branches, needles, etc.).
This woody biomass may be in piles in close proximity to permanent or temporary roads, throughout a
treatment site not near a road, or may be on varying terrain and slopes; the woody biomass may also be
located on public or private property with limited access.
3. QUALIFICATIONS:
Qualifications, at a minimum, include the following items. Proposals are to clearly document explicitly how
each of the following qualifications have been met.
1. Contractor must have a proven track record of successful completion of similar projects, with at least two
(2) completed within the past five (5) years.
2. Contractor must have all necessary licenses required to perform the work.
3. Contractor must have the machinery and workforce to perform woody biomass reduction, removal, and/or
hauling services (use of subcontractors are allowed).
4. Contractors with experience in woody biomass reduction, removal, and/or hauling in mountainous terrain
are preferred.
Page 4 of 11

4. SCOPE OF WORK:
The Contractor at a minimum, will provide, perform, and/or furnish the following:
1. The Contractor will perform reasonable, cost-effective and efficient removal, reduction, hauling, and
disposal of woody biomass generated from project activities, as directed by the County.
2. The Contractor will provide services at a location only after receiving both an authorized Work Order and a
Notice-To-Proceed.
3. The Contractor must respond to Work Order request within 10 calendar days; a sample Work Order is
published with this RFP; see Attachment C for an example.
4. The Contractor must be able to mobilize resources, be onsite, and ready to begin work within 30 calendar
days of receiving an authorized Notice-To-Proceed.
5. The Contractor will ensure that all work follows local, State, and Federal laws, ordinances, and
requirements.
6. The Contractor is responsible for all necessary licenses, permissions, permits, and fees associated with the
work performed.
7. The Contractor will ensure that no equipment or personnel are operating beyond the locations and
properties specifically approved by the County.
8. The Contractor must operate within the requirements of the Occupational Safety and Health Act, Manual
on Uniform Traffic Control Devices and all other applicable federal and state laws, rules, and regulations.
9. The Contractor is solely responsible to assure the safety of contract personnel in all contract activities that
they and their subcontractors perform.
10. The Contractor will provide and take necessary measures to protect the public and Larimer County
personnel during their activities, which may include (but are not limited to):
10.1. Providing for flag person(s), traffic control, crash attenuation, removal of unsafe equipment, and
removal of unsafe workers, as required.
11. County or County-contracted work crews may engage in work in the same or adjacent work areas as the
Contractor or its subcontractors.
12. The Contractor must perform work so as not to interfere with the normal operations of the County, State,
and/or Federal functions, and/or violate existing regulations of these or other regulatory agencies.
13. The Contractor will coordinate and adjust their operations to facilitate the maximum efficiency of all
resources as directed by the County.
14. The Contractor will exercise due care and perform work in a manner to prevent or minimize any damage to
trees, shrubs, landscaping, sidewalks, streets/roads, facilities and general property.
15. The Contractor must repair any damages caused by the Contractor in a timely manner at no expense to
the County.
16. The Contractor will provide all expertise, personnel, tools, materials, equipment, transportation,
supervision, and all other services and facilities necessary to execute and complete the timely removal,
hauling, and disposal of the woody biomass.
17. The Contractor will provide to the County a single point of contact (and an alternate) to coordinate all
removal, hauling, and disposal activities.
18. The Contractor must be responsive to the Larimer County Project Manager and provide updates or
communications in a reasonable fashion, or as requested.
19. The County reserves the right to approve all sub-contractors hired by the Contractor and to require the
Contractor to dismiss a subcontractor upon County request.
20. The Contractor must prepare and submit invoices on a per Work Order basis and may not submit invoices
more frequently than monthly.
21. The Contractor will provide to the County an Event Report, after successful completion of each job as
defined by its associated Work Order, including all relevant information such as (but not limited to): the
amount of material removed, hauled and disposed; a general description of the methods utilized for the
removal, hauling and disposal.
22. No retainer will be paid to the Contractor in order to keep the contract in effect.
23. The Contractor must meet all scope and timeline deliverables and must ensure no cost overruns.
Page 5 of 11

24. The County reserves the right to view, inspect, or review job activities and operations undertaken by the
Contractor at any time.
25. The County reserves the right to issue other contracts or direct other Contractors to perform the same or
similar work within the Project area included in this contract.
26. The County reserves the right to deny or disallow use of any specific machinery or equipment as
determined by the County.
5. INSURANCE:
BEFORE submitting your company proposal, confirm with your insurance carrier that your company can meet
the insurance requirements published in the solicitation. Your company insurance coverages should be
correctly noted in the most current EOC. NOTE: All Larimer County contracts require that the Award Vendor
possess appropriate insurance at all times during the contract; these coverages are purchased at the
company's expense. The County's insurance requirements may necessitate a company adding or increasing
coverage/limits, and those changes may impact pricing for the proposed project. These costs must be included
in your pricing at the time of submission and will not be permitted to be added later.
5a. INSURANCE REQUIREMENTS:
Prior to commencement of any work, contractor/vendor shall provide a Certificate of Insurance issued to
Larimer County, 200 West Oak St., Suite 4000, Fort Collins, Colorado 80521 as the Certificate Holder. The
insurance required herein shall be procured and maintained in full force and effect for the duration of the
Contract or Agreement and shall be written for not less than the following amounts, or greater if required by
law. Such certificate shall be delivered to InsuranceCert@larimer.org.
1. Workers' Compensation and Employers' Liability
1.1. Workers' Compensation: Statutory
1.2. Employer's Liability: $100,000 Each Accident
$500,000 Disease-Policy Limit
$100,000 Disease-Each Employee
1.3. Waiver of Subrogation in favor of Larimer County
1.4. If the contractor/vendor is not required to carry Workers' Compensation coverage per Colorado
Workers' Compensation Act 8-40-202(2)(b) a signed Workers' Compensation waiver must be provided.
2. Commercial General Liability on an Occurrence Form with minimum limits as follows:
2.1. Per Occurrence Limit $1,000,000
2.2. General Aggregate Limit $2,000,000
2.3. Contractor/Vendor agrees that the insurance afforded the County is primary non-contributory.
3. Automobile Liability Insurance including coverage for all owned, non-owned, & hired autos. Limits to be as
follows:
3.1. Bodily Injury & Property Damage Combined Single Limit $1,000,000
3.2. Lower limits may be accepted if automobiles are not used for transport in relation to goods/service
provided as outlined in agreement (i.e. only commuting to job site).
4. Professional Liability/Errors & Omissions $1,000,000
5. Pollution Liability $1,000,000
6. Minimum required limits set forth herein may be met by utilizing a combination of excess/umbrella policies in
conjunction with primary insurance policies if necessary.
7. General Liability and Automobile Liability insurance policies shall include Larimer County and its elected and
appointed officials and employees as additional insureds as their interests may appear.
8. The County reserves the right to reject any insurer it deems not financially acceptable by insurance
industry standards. Insurance Companies shall be licensed to do business in the State of Colorado and
shall have an AM Best rating of not less than A- VII.
9. Notice of Cancellation: Each insurance policy required by the insurance provision of this Contract or
Agreement shall provide the required coverage and shall not be suspended, voided, or canceled. Should
any of the required policies be cancelled before the expiration date, notice shall be delivered to Larimer
County, 200 West Oak St. Suite 4000, Fort Collins, CO 80521 or InsuranceCert@larimer.org.
Page 6 of 11

10. Subcontractors: If subcontractors are used by contractor/vendor in the performance of contracted services,
all subcontractors are required to carry insurance coverage consistent with the limits as listed in this
document and the subcontractor must include Larimer County an additional insured as described in section
V.
ANY DEVIATIONS FROM THE STANDARDS GIVEN ABOVE MUST BE APPROVED BY THE LARIMER
COUNTY RISK MANAGEMENT DIVISION.
Proof of Auto Liability and Workers' Compensation insurance is waived if goods/products are not delivered to a
County facility (delivery is made to roadway or private staging area), or they are delivered by a common carrier
(i.e., private shipper or freight forwarder, etc.).
6. EVALUATION CRITERIA:
Proposal submittals will be individually and independently evaluated and scored by each Evaluation Committee
Member. The criteria below will be the basis for review of the written proposals. The rating scale will be for
available points; receiving the maximum points available per criteria would be considered an outstanding
rating.
POINTS
CRITERIA SUB-CRITERIA
AVAILABLE
* Does the Contractor have the needed experience, expertise and
capability to successfully managing, performing, and complete
Capability and the services required for these projects?
50
Qualifications * Do the Contractor's references and previous work experience
demonstrate their ability to successfully manage, perform, and
complete the scope of work?
* Does the Contractor have the resources required for the variety
of removal and hauling activities that may be required?
Resources
* Does the Contractor have the ability to adequately staff a
and 25
removal and hauling operation, and in a timely manner?
Availability
* Is the Contractor able to respond and complete jobs in a timely
manner?
* Is pricing competitive, reasonable, and advantageous to Larimer
Price County? 20
* Does the proposal indicate good value for the costs incurred?
Adequacy and
* Does the vendor fully understand the specific objective and follow
Completeness 5
the Proposal Submittal Requirements?
Proposal
Maximum Possible Points = 100
7. AWARD AND AGREEMENT:
A formal agreement will be awarded to the vendor with the most responsible, responsive, reasonable proposal,
deemed the best value, best fit, and most advantageous to Larimer County. To assist in the decision for
award: interviews may be held, background checks may be performed, references may be contacted, and
other inquiries may be taken to determine the abilities of the Consultant.
A Sample of Larimer County's "Professional Services Agreement" is included with this Request for Proposal as
Attachment A - Professional Services Agreement. Any exceptions or requested additions to the attached
agreement must be stated and submitted with your Proposal; these requests will not be accepted after the
Proposal has closed. The County makes no guarantee of any changes or concessions but will review and
consider all requests submitted. The contract's Exhibit D, CONTRACT PROVISIONS FOR NON-FEDERAL
ENTITY CONTRACTS UNDER FEDERAL AWARDS, may not be changed and will be part of the
Page 7 of 11

contract. These provisions must be present in any sub-contractor agreement for work performed on this
project.
The term of the agreement will be October 21, 2026 through October 20, 2027. The County, at its sole option,
may offer to extend this Contract for up to four (4) additional one-year terms. The extension option may be
exercised providing satisfactory service is given, and must be mutually agreed upon in writing, by and between
the County and the Award Vendor.
Upon Notice of Award, the Award Vendor will be required to submit a valid Certificate of Insurance (COI) that
meets, at a minimum, the Insurance Requirements published in the solicitation (see example COI below). This
valid COI must be received by Larimer County within 10 calendar days of the Notice of Award and must
include Larimer County listed as Additional Insured and Certificate Holder.
8. PROPOSAL SUBMITTAL REQUIREMENTS:
Please submit your proposal, addressing each of the following items in the order as outlined below. Following
submission directions detailed starting on page two (2) of this solicitation, submit only the two (2) files identified
below:
* 1 - ORIGINAL proposal - Addressing all of the items provided below. This version will be scored by
each member of the Evaluation Committee.
* 1 - REDACTED proposal - This version will be used to satisfy public records requests. This redacted
file may be the same as the original proposal if your original proposal contains nothing that is confidential.
Bidnet will only allow vendors to submit one (1) Original Proposal and (1) Redacted Proposal and it will not let
you add anything other than your Original Proposal and Redacted Proposal and both are limited to one (1) file
each.
Incomplete proposals or proposals that do not address each of the following items in the order as outlined
below may be rejected.
The proposal packet should be numbered sequentially.
1. Signed Signature Page (found below)
2. Table of Contents
3. Completed Byrd Anti-Lobbying Amendment Certification (found below).
4. Colorado Constitution Article XI, 1 and 2 prohibit the County from pledging credit, providing aid, and
accepting debt/liability of another. Because of this, the County is unlikely to accept a Limitation of Liability
provision in the final agreement. Please indicate in your response if you require a Limitation of Liability
provision.
5. The County anticipates that the selected vendor will sign the County's "Professional Services Agreement"
which is included as Attachment A. In this section, you must specifically address any issues with the
agreement and propose solutions.
6. Explicitly describe/explain how your firm meets or exceeds the QUALIFICATIONS stated earlier in this
RFP.
6.1. Contractor must have a proven track record of successful completion of similar projects, with at least
two (2) completed within the past five (5) years.
6.2. Contractor must have all necessary licenses required to perform the work.
6.3. Contractor must have the machinery and workforce to perform woody biomass reduction, removal,
and/or hauling services (use of subcontractors are allowed).
6.4. Contractors having experience with woody biomass reduction, removal, and/or hauling in mountainous
terrain is preferred.
7. Contact
7.1. Identify who will act as the primary contact person to Larimer County.
8. Work Experience
Page 8 of 11

8.1. Summary of similar projects, and tangible examples of at least two (2) completed within the past five
(5) years.
8.2. Provide at least two (2) references that can speak to Contractor performance on similar projects, with
at least one (1) from a similar project completed within the past five (5) years.
9. Contractor Resources
9.1. Provide a list of the various biomass reduction, removal and hauling methods that the Contractor has
capacity to perform.
9.2. Provide a list of machinery or equipment resources that the Contractor may utilize in the work.
9.3. Indicate the total number of employed personnel that may perform work under this contract and how
many resources are in each category (e.g., Administration & Project Management, Laborer, etc.).
10. Certificates
10.1. Attach copies of any relevant certificates, credentials, and/or awards.
11. Safety
11.1. Provide a list of all projects in the last five (5) years that have received an OSHA citation either
to Contractor or subcontractor on the jobsite and provide a narrative for each citation.
12. Complete and submit:
12.1. Attachment B - Fee Structure
12.2. Attachment C - Crystal Lake - CLRRA Slash Depot
12.3. Attachment D - Estes Park - N St Vrain Dr
12.4. Attachment E - N Rim Road
13. Provide a copy of your Evidence of Coverage Certificate (EOC) or Certificate of Insurance (COI) that most
closely reflects the insurance requirements described in this solicitation.
13.1. Provide statements to answer the following questions:
13.1.1. Does coverage meet minimum project requirements?
13.1.2. Can this coverage be extended for work on this project?
13.1.3. Can coverage be increased?
13.1.4. Can the County be listed as an additional insured?
Page 9 of 11

BYRD ANTI-LOBBYING AMENDMENT CERTIFICATION
P26-15 Woody Biomass Removal and Hauling Services
(To be submitted with each bid or offer exceeding $100,000)
The undersigned, [Company] certifies, to the best of his or her knowledge, 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 an 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, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan, or cooperative agreement.
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, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form
- LLL, "Disclosure Form to Report Lobbying," 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 subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) 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 31, U.S.C. 1352 ( as amended by the Lobbying Disclosure Act of 1995). 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.
The Contractor, [Company] ___________, certifies or affirms the truthfulness and accuracy of
each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees
that the provisions of 31 U.S.C. 3801 et seq., apply to this certification and disclosure, if any.
Signature of Contractor's Authorized Official Date
Name and Title of Contractor's Authorized Official
Page 10 of 11