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Exhibit G-3 Certification Regarding the Restrictions of the Use of Federal Funds <br /> for Lobbying <br /> The prospective participant certifies, by signing and submitting this bid or proposal,to the best of his or her <br /> knowledge and belief, that: <br /> 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,to any <br /> person for influencing or attempting to influence an officer or employee of any Federal agency, a Member <br /> of Congress, an officer or employee of Congress, or any employee of a Member of Congress in connection <br /> with the awarding of any Federal contract, the making of any Federal grant,the making of any Federal loan, <br /> the entering into of any cooperative AGREEMENT, and the extension, continuation, renewal, amendment, <br /> or modification of Federal contract, grant, loan or cooperative AGREEMENT. <br /> 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for <br /> influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, <br /> an officer or employee of Congress, or an employee of a Member of Congress in connection with this <br /> Federal contract, grant, loan or cooperative AGREEMENT,the undersigned shall complete and submit <br /> Standard Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. <br /> This certification is a material representation of fact upon which reliance was placed when this transaction <br /> was made or entered into. Submission of this certification is a prerequisite for making or entering into <br /> this transaction imposed by Section 1352, Title 31,U.S. Code. Any person who fails to file the required <br /> certification shall be subject to a civil penalty of not less than $10,000.00, and not more than $100,000.00, <br /> for each such failure. <br /> "The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require <br /> that the language of this certification be included in all lower tier sub-contracts, which exceed $100,000, <br /> and that all such sub-recipients shall certify and disclose accordingly. <br /> Jacobs Project Management Co. <br /> Consultant(Firm Name) <br /> Signature(Authorized Official of Consultant) Date <br /> Agreement Number: <br /> WSDOT Form 140-089 EF Exhibit G Page 1 of 1 <br /> Revised 1013012014 56 <br />