Name of Vendor Signature of Authorized Official / Date Vendor's Address Print Name / Title of Signer City / State / Zip Code EIN Vendor’s Phone Number Email Address Sworn to before me this ________ day of ______________________, 20____________ Notary Public or Commissioner of Deeds EXHIBIT C LOBBYING CERTIFICATION FORM EXHIBIT C LOBBYING CERTIFICATION FORM The City Council has asked City agencies to require vendors funded by City Council discretionary awards to certify that they are in compliance with New York City and New York State Lobbying Laws. For questions concerning this form, contact the agency awarding the contract associated with the discretionary award. For information about lobbying filing requirements, visit: LOBBYING CERTIFICATION The undersigned affirms and declares that the Vendor is in compliance with the lobbying registration requirements of the New York City and New York State Lobbying Laws. See Administrative Code of the City of New York § (“Administrative Code”) et seq. and Legislative Law §1-a et seq., respectively. The registration status is disclosed below. Vendor’s Legal Name of Vendor: Address: City: State: Zip: EIN/TIN: Tel. No.:
Name of Vendor Signature of Authorized Official / Date Vendor's Address Print Name / Title of Signer City / State / Zip Code Vendor’s EIN Phone Number Email Address Sworn to before me this ________ day of ______________________, 20____________ Notary Public or Commissioner of Deeds EXHIBIT C LOBBYING CERTIFICATION FORM EXHIBIT C LOBBYING CERTIFICATION FORM The City Council has asked City agencies to require vendors funded by City Council discretionary awards to certify that they are in compliance with New York City and New York State Lobbying Laws. For questions concerning this form, contact the agency awarding the contract associated with the discretionary award. For information about lobbying filing requirements, visit: LOBBYING CERTIFICATION The undersigned affirms and declares that the Vendor is in compliance with the lobbying registration requirements of the New York City and New York State Lobbying Laws. See Administrative Code of the City of New York (“Administrative Code”) § et seq. and Legislative Law §1-a et seq., respectively. The Vendor’s registration status is disclosed below. Legal Name of Vendor: Address: City: State: Zip: EIN/TIN: Tel. No.:
FY19_FC_100K_and_less.docx