Common use of Certification of Payments Clause in Contracts

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Program/Activity Receiving Federal Grant Funding The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Contractor TBA Program/Activity Receiving Federal Grant Funding Contract #00.xxx - 000 0xx Xxx N Facade Repair & Window Replacement The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Contractor TBA Program/Activity Receiving Federal Grant Funding 1515 Park Switchboard and Generator Replacement The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Contractor TBA Program/Activity Receiving Federal Grant Funding Contract #00.xxx - 314 Hennepin Facade Repair The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Contractor TBA Program/Activity Receiving Federal Grant Funding Contract #00.xxx Xxxxxxxx Xxxxxx - Fire Protection and Fire Alarm Systems Upgrades The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Contractor TBA Program/Activity Receiving Federal Grant Funding Contract #00.xxx - 2121 Minnehaha Apartment Facade Repair The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Contractor TBA Program/Activity Receiving Federal Grant Funding Contract #00.xxx - Pavement Rehab & Repairs The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Program/Activity Receiving Federal Grant Funding Shower Base Refinishing The undersigned certifies, to the best of his or her knowledge and belief, that:

Certification of Payments. to Influence Federal Transactions OMB Approval No. 2577-0157 (Exp. 11/30/2023) U.S. Department of Housing and Urban Development Office of Public and Indian Housing Public reporting burden for this information collection is estimated to average 30 minutes. This includes the time for collecting, reviewing, and reporting data. The information requested is required to obtain a benefit. This form is used to ensure federal funds are not used to influence members of Congress. There are no assurances of confidentiality. HUD may not conduct or sponsor, and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number. Applicant Name Contractor TBA Program/Activity Receiving Federal Grant Funding Contract 00.xxx - Glendale Townhomes The undersigned certifies, to the best of his or her knowledge and belief, that: