3-Lobbyist Registration Requirement Certification
36 KB Posted
- Attached to
- Group Long Term Disability Insurance
- Solicitation number
- GEN2129113P1
- Issued by
- Broward County, Florida
About this file
This document is a Lobbyist Registration Requirement Certification form from Broward County, Florida, related to a Group Long Term Disability Insurance solicitation. The Broward County Human Resources Division is seeking a qualified firm to provide Group Long Term Disability Insurance, including enrollment support and administration services for benefit-eligible employees. The solicitation requires vendors to submit responses electronically through BPRO, with a specific process for asking questions and seeking clarification about the solicitation requirements.
The certification form mandates that vendors disclose any lobbyists retained in connection with the competitive solicitation, certifying compliance with the Broward County Lobbyist Registration Act. Vendors must provide details about any lobbyists, including names, firms, contact information, and confirm timely registration. The solicitation includes additional requirements such as completing a Project Specific Agreement (GEN2129113P1), an ETS Vendor Security Questionnaire, and adhering to the Office of Economic and Small Business Development procurement preferences for small and county business enterprises. Failure to comply with lobbyist registration or providing false information could result in the vendor being deemed non-responsive or potential contract termination.
Text of this file
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
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