16-Lobbyist Registration Requirement Certification.docx

DOCX document 36 KB Posted

Attached to
Wiles Road Westbound Departure Lane Transition Improvements
Solicitation number
PNC2131631C1
Issued by
Florida

About this file

This is a Lobbyist Registration Requirement Certification form required by Broward County, Florida for the Wiles Road Westbound Departure Lane Transition Improvements competitive solicitation. The certification must be completed and submitted with the solicitation response, or within three business days of the County's request. Vendors who fail to comply fully within the stated timeframes may be deemed nonresponsive. The form requires vendors to certify whether they have retained any lobbyist(s) to lobby in connection with the competitive solicitation and, if so, to confirm that each lobbyist has timely filed the required registration or amended registration under the Broward County Lobbyist Registration Act, Sections 1-260 through 1-262 of the Broward County Code of Ordinances.

Vendors must select one of three certification options: confirmation that no lobbyist has been retained for this solicitation (with notice to be provided if one is retained after solicitation), confirmation that lobbyist(s) have been retained and have complied with registration requirements, or provision of specific lobbyist details including names, firms, phone numbers, and email addresses. If the County discovers after contract award that a vendor's certification was erroneous due to willful or intentional error, the County may exercise contractual rights to terminate the contract for convenience. The form was last updated on September 9, 2024, and requires vendor signature, printed name, title, and date of certification.

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Text version

LOBBYIST REGISTRATION REQUIREMENT CERTIFICATION

The completed form should be submitted with the solicitation response but must be submitted within three business days after County’s request. The Vendor may be deemed nonresponsive for failure to fully comply within stated timeframes.

The Vendor certifies that it understands if it has retained a lobbyist(s) to lobby in connection with a competitive solicitation, it shall be deemed nonresponsive unless the firm, in responding to the competitive solicitation, certifies that each lobbyist retained has timely filed the registration or amended registration required under the Broward County Lobbyist Registration Act, Sections 1-260 through 1-262, Broward County Code of Ordinances; and it understands that if, after awarding a contract in connection with the solicitation, the County learns that the certification was erroneous, and upon investigation determines that the error was willful or intentional on the part of the Vendor, the County may, on that basis, exercise any contractual right to terminate the contract for convenience.

The Vendor hereby certifies that: (select one)

☐ It has not retained a lobbyist(s) to lobby in connection with this competitive solicitation; however, if retained after the solicitation, the County will be promptly notified.

☐ It has retained a lobbyist(s) to lobby in connection with this competitive solicitation and certifies that each lobbyist retained has timely filed the registration or amended registration required under Broward County Lobbyist Registration Act, Sections 1-260 through 1-262, Broward County Code of Ordinances.

It is a requirement of this solicitation that the names of any and all lobbyists retained to lobby in connection with this solicitation be listed below:

Name of Lobbyist: Click or tap here to enter text.
Name of Lobbyist: Click or tap here to enter text.
Lobbyist’s Firm: Click or tap here to enter text.
Lobbyist’s Firm: Click or tap here to enter text.
Phone: Click or tap here to enter text.
Phone: Click or tap here to enter text.
E-mail: Click or tap here to enter text.
E-mail: Click or tap here to enter text.

Vendor Name: Click or tap here to enter text.

Signature: ______________________________ Printed Name: Click or tap here to enter text.

Title: Click or tap here to enter text.

Date: Click or tap to enter a date.

Form Date 9/9/24

File details come from the government source that posted it. Updated .