RFB-2027-DCYF-01-MEALD: Meal & Dietary Services for Youth Treatment Center

Appendix B P-37 and Standard Exhibits DO NOT COMPLETE FORM NUMBER P-37 (version 2/23/2023)
Subject:
Notice: This agreement and all of its attachments shall become public upon submission to Governor and
Executive Council for approval. Any information that is private, confidential or proprietary must
be clearly identified to the agency and agreed to in writing prior to signing the contract.
AGREEMENT
The State of New Hampshire and the Contractor hereby mutually agree as follows:
GENERAL PROVISIONS
1. IDENTIFICATION.
1.1 State Agency Name 1.2 State Agency Address
129 Pleasant Street
New Hampshire Department of Health and Human Services Concord, NH 03301-3857
1.3 Contractor Name 1.4 Contractor Address
1.5 Contractor Phone 1.6 Account Unit and Class 1.7 Completion Date 1.8 Price Limitation
Number
1.9 Contracting Officer for State Agency 1.10 State Agency Telephone Number
Robert W. Moore, Director (603) 271-9631
1.11 Contractor Signature 1.12 Name and Title of Contractor Signatory
Date:
1.13 State Agency Signature 1.14 Name and Title of State Agency Signatory
Date:
1.15 Approval by the N.H. Department of Administration, Division of Personnel (if applicable)
By: Director, On:
1.16 Approval by the Attorney General (Form, Substance and Execution) (if applicable)
By: On:
1.17 Approval by the Governor and Executive Council (if applicable)
G&C Item number: G&C Meeting Date:
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2. SERVICES TO BE PERFORMED. The State of New hereof, and shall be the only and the complete compensation to the
Hampshire, acting through the agency identified in block 1.1 Contractor for the Services.
("State"), engages contractor identified in block 1.3 ("Contractor") 5.3 The State reserves the right to offset from any amounts
to perform, and the Contractor shall perform, the work or sale of otherwise payable to the Contractor under this Agreement those
goods, or both, identified and more particularly described in the liquidated amounts required or permitted by N.H. RSA 80:7
attached EXHIBIT B which is incorporated herein by reference through RSA 80:7-c or any other provision of law.
("Services"). 5.4 The State's liability under this Agreement shall be limited to
monetary damages not to exceed the total fees paid. The Contractor
3. EFFECTIVE DATE/COMPLETION OF SERVICES. agrees that it has an adequate remedy at law for any breach of this
3.1 Notwithstanding any provision of this Agreement to the Agreement by the State and hereby waives any right to specific
contrary, and subject to the approval of the Governor and performance or other equitable remedies against the State.
Executive Council of the State of New Hampshire, if applicable,
this Agreement, and all obligations of the parties hereunder, shall 6. COMPLIANCE BY CONTRACTOR WITH LAWS AND
become effective on the date the Governor and Executive Council REGULATIONS/EQUAL EMPLOYMENT
approve this Agreement, unless no such approval is required, in OPPORTUNITY.
which case the Agreement shall become effective on the date the 6.1 In connection with the performance of the Services, the
Agreement is signed by the State Agency as shown in block 1.13 Contractor shall comply with all applicable statutes, laws,
("Effective Date"). regulations, and orders of federal, state, county or municipal
3.2 If the Contractor commences the Services prior to the Effective authorities which impose any obligation or duty upon the
Date, all Services performed by the Contractor prior to the Contractor, including, but not limited to, civil rights and equal
Effective Date shall be performed at the sole risk of the Contractor, employment opportunity laws and the Governor's order on Respect
and in the event that this Agreement does not become effective, the and Civility in the Workplace, Executive order 2020-01. In
State shall have no liability to the Contractor, including without addition, if this Agreement is funded in any part by monies of the
limitation, any obligation to pay the Contractor for any costs United States, the Contractor shall comply with all federal
incurred or Services performed. executive orders, rules, regulations and statutes, and with any rules,
3.3 Contractor must complete all Services by the Completion Date regulations and guidelines as the State or the United States issue to
specified in block 1.7. implement these regulations. The Contractor shall also comply
with all applicable intellectual property laws.
4. CONDITIONAL NATURE OF AGREEMENT. 6.2 During the term of this Agreement, the Contractor shall not
Notwithstanding any provision of this Agreement to the contrary, discriminate against employees or applicants for employment
all obligations of the State hereunder, including, without limitation, because of age, sex, sexual orientation, race, color, marital status,
the continuance of payments hereunder, are contingent upon the physical or mental disability, religious creed, national origin,
availability and continued appropriation of funds. In no event shall gender identity, or gender expression, and will take affirmative
the State be liable for any payments hereunder in excess of such action to prevent such discrimination, unless exempt by state or
available appropriated funds. In the event of a reduction or federal law. The Contractor shall ensure any subcontractors
termination of appropriated funds by any state or federal legislative comply with these nondiscrimination requirements.
or executive action that reduces, eliminates or otherwise modifies 6.3 No payments or transfers of value by Contractor or its
the appropriation or availability of funding for this Agreement and representatives in connection with this Agreement have or shall be
the Scope for Services provided in EXHIBIT B, in whole or in part, made which have the purpose or effect of public or commercial
the State shall have the right to withhold payment until such funds bribery, or acceptance of or acquiescence in extortion, kickbacks,
become available, if ever, and shall have the right to reduce or or other unlawful or improper means of obtaining business.
terminate the Services under this Agreement immediately upon 6.4. The Contractor agrees to permit the State or United States
giving the Contractor notice of such reduction or termination. The access to any of the Contractor's books, records and accounts for
State shall not be required to transfer funds from any other account the purpose of ascertaining compliance with this Agreement and
or source to the Account identified in block 1.6 in the event funds all rules, regulations and orders pertaining to the covenants, terms
in that Account are reduced or unavailable. and conditions of this Agreement.
5. CONTRACT PRICE/PRICE LIMITATION/ PAYMENT. 7. PERSONNEL.
5.1 The contract price, method of payment, and terms of payment 7.1 The Contractor shall at its own expense provide all personnel
are identified and more particularly described in EXHIBIT C necessary to perform the Services. The Contractor warrants that all
which is incorporated herein by reference. personnel engaged in the Services shall be qualified to perform the
5.2 Notwithstanding any provision in this Agreement to the Services, and shall be properly licensed and otherwise authorized
contrary, and notwithstanding unexpected circumstances, in no to do so under all applicable laws.
event shall the total of all payments authorized, or actually made 7.2 The Contracting Officer specified in block 1.9, or any
hereunder, exceed the Price Limitation set forth in block 1.8. The successor, shall be the State's point of contact pertaining to this
payment by the State of the contract price shall be the only and the Agreement.
complete reimbursement to the Contractor for all expenses, of
whatever nature incurred by the Contractor in the performance
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8. EVENT OF DEFAULT/REMEDIES. 10.2 All data and any Property which has been received from the
8.1 Any one or more of the following acts or omissions of the State, or purchased with funds provided for that purpose under this
Contractor shall constitute an event of default hereunder ("Event Agreement, shall be the property of the State, and shall be returned
of Default"): to the State upon demand or upon termination of this Agreement
8.1.1 failure to perform the Services satisfactorily or on schedule; for any reason.
8.1.2 failure to submit any report required hereunder; and/or 10.3 Disclosure of data, information and other records shall be
8.1.3 failure to perform any other covenant, term or condition of governed by N.H. RSA chapter 91-A and/or other applicable law.
this Agreement. Disclosure requires prior written approval of the State.
8.2 Upon the occurrence of any Event of Default, the State may
take any one, or more, or all, of the following actions: 11. CONTRACTOR'S RELATION TO THE STATE. In the
8.2.1 give the Contractor a written notice specifying the Event of performance of this Agreement the Contractor is in all respects an
Default and requiring it to be remedied within, in the absence of a independent contractor, and is neither an agent nor an employee of
greater or lesser specification of time, thirty (30) calendar days the State. Neither the Contractor nor any of its officers, employees,
from the date of the notice; and if the Event of Default is not timely agents or members shall have authority to bind the State or receive
cured, terminate this Agreement, effective two (2) calendar days any benefits, workers' compensation or other emoluments
after giving the Contractor notice of termination; provided by the State to its employees.
8.2.2 give the Contractor a written notice specifying the Event of
Default and suspending all payments to be made under this 12. ASSIGNMENT/DELEGATION/SUBCONTRACTS.
Agreement and ordering that the portion of the contract price which 12.1 Contractor shall provide the State written notice at least fifteen
would otherwise accrue to the Contractor during the period from (15) calendar days before any proposed assignment, delegation, or
the date of such notice until such time as the State determines that other transfer of any interest in this Agreement. No such
the Contractor has cured the Event of Default shall never be paid assignment, delegation, or other transfer shall be effective without
to the Contractor; the written consent of the State.
8.2.3 give the Contractor a written notice specifying the Event of 12.2 For purposes of paragraph 12, a Change of Control shall
Default and set off against any other obligations the State may owe constitute assignment. "Change of Control" means (a) merger,
to the Contractor any damages the State suffers by reason of any consolidation, or a transaction or series of related transactions in
Event of Default; and/or which a third party, together with its affiliates, becomes the direct
8.2.4 give the Contractor a written notice specifying the Event of or indirect owner of fifty percent (50%) or more of the voting
Default, treat the Agreement as breached, terminate the Agreement shares or similar equity interests, or combined voting power of the
and pursue any of its remedies at law or in equity, or both. Contractor, or (b) the sale of all or substantially all of the assets of
the Contractor.
9. TERMINATION. 12.3 None of the Services shall be subcontracted by the Contractor
9.1 Notwithstanding paragraph 8, the State may, at its sole without prior written notice and consent of the State.
discretion, terminate the Agreement for any reason, in whole or in 12.4 The State is entitled to copies of all subcontracts and
part, by thirty (30) calendar days written notice to the Contractor assignment agreements and shall not be bound by any provisions
that the State is exercising its option to terminate the Agreement. contained in a subcontract or an assignment agreement to which it
9.2 In the event of an early termination of this Agreement for any is not a party.
reason other than the completion of the Services, the Contractor
shall, at the State's discretion, deliver to the Contracting Officer, 13. INDEMNIFICATION. The Contractor shall indemnify,
not later than fifteen (15) calendar days after the date of defend, and hold harmless the State, its officers, and employees
termination, a report ("Termination Report") describing in detail from and against all actions, claims, damages, demands,
all Services performed, and the contract price earned, to and judgments, fines, liabilities, losses, and other expenses, including,
including the date of termination. In addition, at the State's without limitation, reasonable attorneys' fees, arising out of or
discretion, the Contractor shall, within fifteen (15) calendar days relating to this Agreement directly or indirectly arising from death,
of notice of early termination, develop and submit to the State a personal injury, property damage, intellectual property
transition plan for Services under the Agreement. infringement, or other claims asserted against the State, its officers,
or employees caused by the acts or omissions of negligence,
10. PROPERTY OWNERSHIP/DISCLOSURE. reckless or willful misconduct, or fraud by the Contractor, its
10.1 As used in this Agreement, the word "Property" shall mean employees, agents, or subcontractors. The State shall not be liable
all data, information and things developed or obtained during the for any costs incurred by the Contractor arising under this
performance of, or acquired or developed by reason of, this paragraph 13. Notwithstanding the foregoing, nothing herein
Agreement, including, but not limited to, all studies, reports, files, contained shall be deemed to constitute a waiver of the State's
formulae, surveys, maps, charts, sound recordings, video sovereign immunity, which immunity is hereby reserved to the
recordings, pictorial reproductions, drawings, analyses, graphic State. This covenant in paragraph 13 shall survive the termination
representations, computer programs, computer printouts, notes, of this Agreement.
letters, memoranda, papers, and documents, all whether finished or
unfinished.
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14. INSURANCE. 18. AMENDMENT. This Agreement may be amended, waived or
14.1 The Contractor shall, at its sole expense, obtain and discharged only by an instrument in writing signed by the parties
continuously maintain in force, and shall require any subcontractor hereto and only after approval of such amendment, waiver or
or assignee to obtain and maintain in force, the following discharge by the Governor and Executive Council of the State of
insurance: New Hampshire unless no such approval is required under the
14.1.1 commercial general liability insurance against all claims of circumstances pursuant to State law, rule or policy.
bodily injury, death or property damage, in amounts of not less than
$1,000,000 per occurrence and $2,000,000 aggregate or excess; 19. CHOICE OF LAW AND FORUM.
and 19.1 This Agreement shall be governed, interpreted and construed
14.1.2 special cause of loss coverage form covering all Property in accordance with the laws of the State of New Hampshire except
subject to subparagraph 10.2 herein, in an amount not less than where the Federal supremacy clause requires otherwise. The
80% of the whole replacement value of the Property. wording used in this Agreement is the wording chosen by the
14.2 The policies described in subparagraph 14.1 herein shall be on parties to express their mutual intent, and no rule of construction
policy forms and endorsements approved for use in the State of shall be applied against or in favor of any party.
New Hampshire by the N.H. Department of Insurance, and issued 19.2 Any actions arising out of this Agreement, including the
by insurers licensed in the State of New Hampshire. breach or alleged breach thereof, may not be submitted to binding
14.3 The Contractor shall furnish to the Contracting Officer arbitration, but must, instead, be brought and maintained in the
identified in block 1.9, or any successor, a certificate(s) of Merrimack County Superior Court of New Hampshire which shall
insurance for all insurance required under this Agreement. At the have exclusive jurisdiction thereof.
request of the Contracting Officer, or any successor, the Contractor
shall provide certificate(s) of insurance for all renewal(s) of 20. CONFLICTING TERMS. In the event of a conflict between
insurance required under this Agreement. The certificate(s) of the terms of this P-37 form (as modified in EXHIBIT A) and any
insurance and any renewals thereof shall be attached and are other portion of this Agreement including any attachments thereto,
incorporated herein by reference. the terms of the P-37 (as modified in EXHIBIT A) shall control.
15. WORKERS' COMPENSATION. 21. THIRD PARTIES. This Agreement is being entered into for
15.1 By signing this agreement, the Contractor agrees, certifies and the sole benefit of the parties hereto, and nothing herein, express or
warrants that the Contractor is in compliance with or exempt from, implied, is intended to or will confer any legal or equitable right,
the requirements of N.H. RSA chapter 281-A ("Workers' benefit, or remedy of any nature upon any other person.
Compensation").
15.2 To the extent the Contractor is subject to the requirements of 22. HEADINGS. The headings throughout the Agreement are for
N.H. RSA chapter 281-A, Contractor shall maintain, and require reference purposes only, and the words contained therein shall in
any subcontractor or assignee to secure and maintain, payment of no way be held to explain, modify, amplify or aid in the
Workers' Compensation in connection with activities which the interpretation, construction or meaning of the provisions of this
person proposes to undertake pursuant to this Agreement. The Agreement.
Contractor shall furnish the Contracting Officer identified in block
1.9, or any successor, proof of Workers' Compensation in the 23. SPECIAL PROVISIONS. Additional or modifying
manner described in N.H. RSA chapter 281-A and any applicable provisions set forth in the attached EXHIBIT A are incorporated
renewal(s) thereof, which shall be attached and are incorporated herein by reference.
herein by reference. The State shall not be responsible for payment
of any Workers' Compensation premiums or for any other claim or 24. FURTHER ASSURANCES. The Contractor, along with its
benefit for Contractor, or any subcontractor or employee of agents and affiliates, shall, at its own cost and expense, execute any
Contractor, which might arise under applicable State of New additional documents and take such further actions as may be
Hampshire Workers' Compensation laws in connection with the reasonably required to carry out the provisions of this Agreement
performance of the Services under this Agreement. and give effect to the transactions contemplated hereby.
16. WAIVER OF BREACH. A State's failure to enforce its rights 25. SEVERABILITY. In the event any of the provisions of this
with respect to any single or continuing breach of this Agreement Agreement are held by a court of competent jurisdiction to be
shall not act as a waiver of the right of the State to later enforce any contrary to any state or federal law, the remaining provisions of
such rights or to enforce any other or any subsequent breach. this Agreement will remain in full force and effect.
17. NOTICE. Any notice by a party hereto to the other party shall 26. ENTIRE AGREEMENT. This Agreement, which may be
be deemed to have been duly delivered or given at the time of executed in a number of counterparts, each of which shall be
mailing by certified mail, postage prepaid, in a United States Post deemed an original, constitutes the entire agreement and
Office addressed to the parties at the addresses given in blocks 1.2 understanding between the parties, and supersedes all prior
and 1.4, herein. agreements and understandings with respect to the subject matter
hereof.
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Appendix B - P37 and Standard Exhibits
Do Not Return
New Hampshire Department of Health and Human Services
Exhibit A
REVISIONS TO STANDARD CONTRACT PROVISIONS
1 Revisions to Form P-37, General Provisions
1.1 Paragraph 6, Subparagraph 6.1., Compliance by Contractor with Laws and
Regulations/Equal Employment Opportunity, is amended as follows:
6.1 In connection with the performance of the Services, the Contractor shall
comply with all applicable statutes, laws, regulations, and orders of
federal, state, county or municipal authorities which impose any
obligation or duty upon the Contractor, including, but not limited to, RSA
151:21 Patients' Bill of Rights, civil rights and equal employment
opportunity laws, and the Governor's order on Respect and Civility in the
Workplace, Executive order 2020-01. In addition, if this Agreement is
funded in any part by monies of the United States, the Contractor shall
comply with all federal executive orders, rules, regulations and statutes,
and with any rules, regulations and guidelines as the State or the United
States issue to implement these regulations. The Contractor shall also
comply with all applicable intellectual property laws.
1.2 Paragraph 12, Assignment/Delegation/Subcontracts, is amended by adding
subparagraph 12.5 as follows:
12.5 Subcontractors are subject to the same contractual conditions as the
Contractor and the Contractor is responsible to ensure subcontractor
compliance with those conditions. The Contractor shall have written
agreements with all subcontractors, specifying the work to be performed,
and if applicable, a Business Associate Agreement in accordance with
the Health Insurance Portability and Accountability Act. Written
agreements shall specify how corrective action shall be managed. The
Contractor shall manage the subcontractor's performance on an ongoing
basis and take corrective action as necessary. The Contractor shall
annually provide the State with a list of all subcontractors provided for
under this Agreement and notify the State of any inadequate
subcontractor performance .
Do Not Return
Exhibit A - Revisions to Standard Contract Provisions Contractor Initials
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Appendix B - P37 and Standard Exhibits
Do Not Return
New Hampshire Department of Health and Human Services
EXHIBIT B
Scope of Services
See Appendix A - Scope of Services. The final Scope of Services is subject to modification based on
the proposal submitted by the selected Vendor, as negotiated with the Department through the
procurement process.
Do Not Return
Contractor Initials
Vendor Name Page 1 of 1 Date

Appendix B - P37 and Standard Exhibits
Do Not Return
New Hampshire Department of Health and Human Services
EXHIBIT C
Payment Terms
To be drafted in accordance with the selected Vendor's proposal, as negotiated
with the Department through the procurement process.
Exhibit C Contractor Initials
Do Not Return
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Appendix B P-37 and Standard Exhibits
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New Hampshire Department of Health and Human Services
Exhibit D - Federal Requirements
SECTION A: CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
The Contractor identified in Section 1.3 of the General Provisions agrees to comply with the provisions
of Sections 5151-5160 of the Drug-Free Workplace Act of 1988 (Pub. L. 100-690, Title V, Subtitle D; 41
U.S.C. 701 et seq.), and further agrees to have the Contractor's representative, as identified in Sections
1.11 and 1.12 of the General Provisions execute the following Certification:
ALTERNATIVE I - FOR CONTRACTORS OTHER THAN INDIVIDUALS
US DEPARTMENT OF HEALTH AND HUMAN SERVICES - CONTRACTORS
US DEPARTMENT OF EDUCATION - CONTRACTORS
US DEPARTMENT OF AGRICULTURE - CONTRACTORS
This certification is required by the regulations implementing Sections 5151-5160 of the Drug-Free
Workplace Act of 1988 (Pub. L. 100-690, Title V, Subtitle D; 41 U.S.C. 701 et seq.). The January 31,
1989 regulations were amended and published as Part II of the May 25, 1990 Federal Register (pages
21681-21691), and require certification by contractors (and by inference, sub- contractors), prior to
award, that they will maintain a drug-free workplace. Section 3017.630(c) of the regulation provides that
a contractor (and by inference, sub-contractors) that is a State may elect to make one certification to the
Department in each federal fiscal year in lieu of certificates for each Agreement during the federal fiscal
year covered by the certification. The certificate set out below is a material representation of fact upon
which reliance is placed when the agency awards the Agreement. False certification or violation of the
certification shall be grounds for suspension of payments, suspension or termination of Agreements, or
government wide suspension or debarment. Contractors using this form should send it to:
Commissioner
NH Department of Health and Human Services
129 Pleasant Street
Concord, NH 03301-6505
1. The Contractor certifies that it will or will continue to provide a drug-free workplace by:
1.1. Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession or use of a controlled substance is prohibited in the Contractor's
workplace and specifying the actions that will be taken against employees for violation of such
prohibition;
1.2. Establishing an ongoing drug-free awareness program to inform employees about
1.2.1. The dangers of drug abuse in the workplace;
1.2.2. The Contractor's policy of maintaining a drug-free workplace;
1.2.3. Any available drug counseling, rehabilitation, and employee assistance programs; and
1.2.4. The penalties that may be imposed upon employees for drug abuse violations occurring
in the workplace;
1.3. Making it a requirement that each employee to be engaged in the performance of the
Agreement be given a copy of the statement required by paragraph (a);
1.4. Notifying the employee in the statement required by paragraph (a) that, as a condition of
employment under the Agreement, the employee will
1.4.1. Abide by the terms of the statement; and
1.4.2. Notify the employer in writing of his or her conviction for a violation of a criminal drug
statute occurring in the workplace no later than five calendar days after such conviction;
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New Hampshire Department of Health and Human Services
Exhibit D - Federal Requirements
1.5. Notifying the agency in writing, within ten calendar days after receiving notice under
subparagraph 1.4.2 from an employee or otherwise receiving actual notice of such conviction.
Employers of convicted employees must provide notice, including position title, to every contract
officer on whose contract activity the convicted employee was working, unless the Federal
agency has designated a central point for the receipt of such notices. Notice shall include the
identification number(s) of each affected Agreement;
1.6. Taking one of the following actions, within 30 calendar days of receiving notice under
subparagraph 1.4.2, with respect to any employee who is so convicted
1.6.1. Taking appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
1.6.2. Requiring such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a Federal, State, or local health,
law enforcement, or other appropriate agency;
1.7. Making a good faith effort to continue to maintain a drug-free workplace through implementation
of paragraphs 1.1, 1.2, 1.3, 1.4, 1.5, and 1.6.
2. The Contractor may insert in the space provided below the site(s) for the performance of work done
in connection with the specific Agreement.
Place of Performance (street address, city, county, state, zip code) (list each location)
Check if there are workplaces on file that are not identified here.

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New Hampshire Department of Health and Human Services
Exhibit D - Federal Requirements
SECTION B: CERTIFICATION REGARDING LOBBYING
The Contractor identified in Section 1.3 of the General Provisions agrees to comply with the provisions
of Section 319 of Public Law 101-121, Government wide Guidance for New Restrictions on Lobbying,
and Byrd Anti-Lobbying Amendment (31 U.S.C. 1352), and further agrees to have the Contractor's
representative, as identified in Sections 1.11 and 1.12 of the General Provisions execute the following
Certification:
US DEPARTMENT OF HEALTH AND HUMAN SERVICES - CONTRACTORS
US DEPARTMENT OF EDUCATION - CONTRACTORS
US DEPARTMENT OF AGRICULTURE - CONTRACTORS
Programs (indicate applicable program covered):
*Temporary Assistance to Needy Families under Title IV-A
*Child Support Enforcement Program under Title IV-D
*Social Services Block Grant Program under Title XX
*Medicaid Program under Title XIX
*Community Services Block Grant under Title VI
*Child Care Development Block Grant under Title IV
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, continuation, renewal,
amendment, or modification of any Federal contract, loan, or cooperative agreement (and by
specific mention sub-contractor).
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, loan, or cooperative agreement (and by specific mention sub- contractor), the
undersigned shall complete and submit Standard Form LLL, (Disclosure Form to Report Lobbying,
in accordance with its instructions, see https://omb.report/icr/201009-0348-022/doc/20388401
3. The undersigned shall require that the language of this certification be included in the award
document for sub-awards at all tiers (including subcontracts, and contracts under grants, loans, and
cooperative agreements) and that all sub-recipients 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.
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Federal Requirements Date
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