NASA Grants Certifications and Assurances

INDEX

ASSURANCE OF COMPLIANCE WITH THE NATIONAL AERONAUTICS AND SPACE
ADMINISTRATION REGULATIONS PURSUANT TO NONDISCRIMINATION IN FEDERALLY
ASSISTED PROGRAMS

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS\--PRIMARY COVERED TRANSACTIONS

*This certification is required by the regulations implementing
Executive Order 12549, Debarment and Suspension, 34 CFR Part 85, Section
85.510, Participant\'s responsibilities. The regulations were published
as Part VII of the May 26, 1988 Federal Register (pages 19160 - 19211).*

APPENDIX A TO PART 1271 - CERTIFICATION REGARDING LOBBYING

*This certification is required under 34 CFR Part 82,"New Restrictions
on Lobbying.*

  -----------------------------------------------------------------------
  Applicants should refer to the regulations cited above to determine the
  certification to which they are required to attest. Applicants should
  also review the instructions for certification included in the
  regulations before completing these forms. Signature of these forms
  provides for compliance with certification requirements under 34 CFR
  Part 82, "New Restrictions on Lobbying", and 34 CFR Part 85,
  Government-wide Debarment and Suspension (Nonprocurement). The
  certifications shall be treated as a material representation of fact
  upon which reliance will be placed when the NASA determines to award
  the covered transaction, grant, or cooperative agreement.

  -----------------------------------------------------------------------

+--------+--------+---------------+---+-------------------------------+
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| ##     |        |               |   |                               |
+--------+--------+---------------+---+-------------------------------+
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| AGREES |        |               |   |                               |
| THAT   |        |               |   |                               |
| it     |        |               |   |                               |
| will   |        |               |   |                               |
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| with   |        |               |   |                               |
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| the    |        |               |   |                               |
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| Rights |        |               |   |                               |
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| 1964   |        |               |   |                               |
| (P.L.  |        |               |   |                               |
| 88     |        |               |   |                               |
| -352), |        |               |   |                               |
| Title  |        |               |   |                               |
| IX of  |        |               |   |                               |
| the    |        |               |   |                               |
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| dments |        |               |   |                               |
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| 1962   |        |               |   |                               |
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| (42    |        |               |   |                               |
| U.S.C. |        |               |   |                               |
| 16101  |        |               |   |                               |
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| seq),  |        |               |   |                               |
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| and    |        |               |   |                               |
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| any    |        |               |   |                               |
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| essary |        |               |   |                               |
| to     |        |               |   |                               |
| effe   |        |               |   |                               |
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|        |        |               |   |                               |
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| licant |        |               |   |                               |
| by     |        |               |   |                               |
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| this   |        |               |   |                               |
| ass    |        |               |   |                               |
| urance |        |               |   |                               |
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| any    |        |               |   |                               |
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| for    |        |               |   |                               |
| the    |        |               |   |                               |
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| which  |        |               |   |                               |
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| real   |        |               |   |                               |
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| p      |        |               |   |                               |
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| by     |        |               |   |                               |
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|        |        |               |   |                               |
| THIS   |        |               |   |                               |
| ASS    |        |               |   |                               |
| URANCE |        |               |   |                               |
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| ration |        |               |   |                               |
| of and |        |               |   |                               |
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| urpose |        |               |   |                               |
| of     |        |               |   |                               |
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| any    |        |               |   |                               |
| and    |        |               |   |                               |
| all    |        |               |   |                               |
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| ederal |        |               |   |                               |
| g      |        |               |   |                               |
| rants, |        |               |   |                               |
| loans, |        |               |   |                               |
| cont   |        |               |   |                               |
| racts, |        |               |   |                               |
| pro    |        |               |   |                               |
| perty, |        |               |   |                               |
| disc   |        |               |   |                               |
| ounts, |        |               |   |                               |
| or     |        |               |   |                               |
| other  |        |               |   |                               |
| f      |        |               |   |                               |
| ederal |        |               |   |                               |
| fin    |        |               |   |                               |
| ancial |        |               |   |                               |
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| stance |        |               |   |                               |
| ex     |        |               |   |                               |
| tended |        |               |   |                               |
| after  |        |               |   |                               |
| the    |        |               |   |                               |
| date   |        |               |   |                               |
| hereof |        |               |   |                               |
| to the |        |               |   |                               |
| App    |        |               |   |                               |
| licant |        |               |   |                               |
| by     |        |               |   |                               |
| NASA,  |        |               |   |                               |
| inc    |        |               |   |                               |
| luding |        |               |   |                               |
| insta  |        |               |   |                               |
| llment |        |               |   |                               |
| pa     |        |               |   |                               |
| yments |        |               |   |                               |
| after  |        |               |   |                               |
| such   |        |               |   |                               |
| date   |        |               |   |                               |
| on     |        |               |   |                               |
| a      |        |               |   |                               |
| ccount |        |               |   |                               |
| of     |        |               |   |                               |
| applic |        |               |   |                               |
| ations |        |               |   |                               |
| for    |        |               |   |                               |
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| stance |        |               |   |                               |
| which  |        |               |   |                               |
| were   |        |               |   |                               |
| ap     |        |               |   |                               |
| proved |        |               |   |                               |
| before |        |               |   |                               |
| such   |        |               |   |                               |
| date.  |        |               |   |                               |
| The    |        |               |   |                               |
| App    |        |               |   |                               |
| licant |        |               |   |                               |
| reco   |        |               |   |                               |
| gnized |        |               |   |                               |
| and    |        |               |   |                               |
| agrees |        |               |   |                               |
| that   |        |               |   |                               |
| such   |        |               |   |                               |
| f      |        |               |   |                               |
| ederal |        |               |   |                               |
| fin    |        |               |   |                               |
| ancial |        |               |   |                               |
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| stance |        |               |   |                               |
| will   |        |               |   |                               |
| be     |        |               |   |                               |
| ex     |        |               |   |                               |
| tended |        |               |   |                               |
| in     |        |               |   |                               |
| re     |        |               |   |                               |
| liance |        |               |   |                               |
| on the |        |               |   |                               |
| rep    |        |               |   |                               |
| resent |        |               |   |                               |
| ations |        |               |   |                               |
| and    |        |               |   |                               |
| agre   |        |               |   |                               |
| ements |        |               |   |                               |
| made   |        |               |   |                               |
| in     |        |               |   |                               |
| this   |        |               |   |                               |
| assu   |        |               |   |                               |
| rance, |        |               |   |                               |
| and    |        |               |   |                               |
| that   |        |               |   |                               |
| the    |        |               |   |                               |
| United |        |               |   |                               |
| States |        |               |   |                               |
| shall  |        |               |   |                               |
| have   |        |               |   |                               |
| the    |        |               |   |                               |
| right  |        |               |   |                               |
| to     |        |               |   |                               |
| seek   |        |               |   |                               |
| ju     |        |               |   |                               |
| dicial |        |               |   |                               |
| enfor  |        |               |   |                               |
| cement |        |               |   |                               |
| of     |        |               |   |                               |
| this   |        |               |   |                               |
| assu   |        |               |   |                               |
| rance. |        |               |   |                               |
| This   |        |               |   |                               |
| ass    |        |               |   |                               |
| urance |        |               |   |                               |
| is     |        |               |   |                               |
| b      |        |               |   |                               |
| inding |        |               |   |                               |
| on the |        |               |   |                               |
| Appl   |        |               |   |                               |
| icant, |        |               |   |                               |
| its    |        |               |   |                               |
| succe  |        |               |   |                               |
| ssors, |        |               |   |                               |
| transf |        |               |   |                               |
| erees, |        |               |   |                               |
| and    |        |               |   |                               |
| assi   |        |               |   |                               |
| gnees, |        |               |   |                               |
| and    |        |               |   |                               |
| the    |        |               |   |                               |
| person |        |               |   |                               |
| or     |        |               |   |                               |
| p      |        |               |   |                               |
| ersons |        |               |   |                               |
| whose  |        |               |   |                               |
| sign   |        |               |   |                               |
| atures |        |               |   |                               |
| appear |        |               |   |                               |
| below  |        |               |   |                               |
| are    |        |               |   |                               |
| auth   |        |               |   |                               |
| orized |        |               |   |                               |
| to     |        |               |   |                               |
| sign   |        |               |   |                               |
| on     |        |               |   |                               |
| behalf |        |               |   |                               |
| of the |        |               |   |                               |
| Appl   |        |               |   |                               |
| icant. |        |               |   |                               |
+--------+--------+---------------+---+-------------------------------+
| Dated: |        |               | # | # [        ]{.underline}      |
| [      |        |               |   |                               |
|        |        |               |   | # *(Applicant)*               |
|  ]     |        |               |   |                               |
| {.unde |        |               |   |                               |
| rline} |        |               |   |                               |
+--------+--------+---------------+---+-------------------------------+
|        |        |               | # | # [   ]{.underline}           |
|        |        |               |   |                               |
|        |        |               | B | # *(Preside                   |
|        |        |               | y | nt, Chairman of Board, or com |
|        |        |               |   | parable authorized official)* |
+--------+--------+---------------+---+-------------------------------+
| [      |        |               | # | #                             |
|        |        |               |   |                               |
|  ]     |        |               |   |                               |
| {.unde |        |               |   |                               |
| rline} |        |               |   |                               |
+--------+--------+---------------+---+-------------------------------+
| [      |        |               | # | #                             |
|        |        |               |   |                               |
|  ]     |        |               |   |                               |
| {.unde |        |               |   |                               |
| rline} |        |               |   |                               |
|        |        |               |   |                               |
| *      |        |               |   |                               |
| (Appli |        |               |   |                               |
| cant's |        |               |   |                               |
| m      |        |               |   |                               |
| ailing |        |               |   |                               |
| add    |        |               |   |                               |
| ress)* |        |               |   |                               |
+--------+--------+---------------+---+-------------------------------+
|        |        |               |   |                               |
+--------+--------+---------------+---+-------------------------------+

#### Certification Regarding

Debarment, Suspension, and Other Responsibility Matters

Primary Covered Transactions

\(1\) The prospective primary participant certifies to the best of its
knowledge and belief, that it and its principals:

(a) Are not presently debarred, suspended, proposed for debarment,
    declared ineligible, or voluntarily excluded from covered
    transactions by any Federal department or agency;

(b) Have not within a three-year period preceding this proposal been
    convicted of or had a civil judgment rendered against them for
    commission of fraud or a criminal offense in connection with
    obtaining, attempting to obtain, or performing a public (Federal,
    State, or local) transaction or contract under a public transaction;
    violation of Federal or State antitrust statutes or commission of
    embezzlement, theft, forgery, bribery, falsification or destruction
    of records, making false statements, or receiving stolen property;

(c) Are not presently indicted for or otherwise criminally or civilly
    charged by a governmental entity (Federal, State, or local) with
    commission of any of the offenses enumerated in paragraph (1)(b) of
    this certification; and

(d) Have not within a three-year period preceding this
    application/proposal had one or more public transactions (Federal,
    State, or local) terminated for cause or default.

\(2\) Where the prospective primary participant is unable to certify to
any of the statements in this certification, such prospective
participant shall attach an explanation to this proposal.

  -------------------------------------------- --------------------------
  Proposal Identification:[                    
   ]{.underline}                               

  Organization Name:[        ]{.underline}     

  Name and Title of Authorized                 
  Representative:[        ]{.underline}        

  Signature:[   ]{.underline}                  Date:[      
                                                ]{.underline}
  -------------------------------------------- --------------------------

#### Certification Regarding Lobbying

#### for Contracts, Grants, Loans, and Cooperative Agreements

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, 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 connnection with the 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 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.

  -------------------------------------------- --------------------------
  Proposal Identification:[                    
   ]{.underline}                               

  Organization Name:[        ]{.underline}     

  Name and Title of Authorized                 
  Representative:[        ]{.underline}        

  Signature:[   ]{.underline}                  Date:[      
                                                ]{.underline}
  -------------------------------------------- --------------------------