5-Lobbyist Registration Requirement Certification.docx
DOCX document 36 KB Posted
- Attached to
- Taxilane ADG III Westside (Taxilane D)
- Solicitation number
- PNC2131441C1
- Issued by
- Florida
About this file
This is a Lobbyist Registration Requirement Certification form required by Broward County, Florida for the Taxilane ADG III Westside (Taxilane D) construction project at Fort Lauderdale-Hollywood International Airport. The certification must be submitted with the solicitation response, though it may be submitted within three business days after the County's request if not included initially. Vendors who fail to comply with the submission timeframe may be deemed nonresponsive. The form requires vendors to certify whether they have retained lobbyists 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). If lobbyists have been retained, vendors must provide complete information including the names, firms, phone numbers, and email addresses of all retained lobbyists.
The County reserves the right to terminate a contract for convenience if it determines after award that a vendor's certification was erroneous and that the error was willful or intentional. Vendors must select one of three certification options: confirmation that no lobbyists have been retained (with notification required if retained after the solicitation); confirmation that lobbyists have been retained and have timely filed required registrations; or acknowledgment that they understand the registration requirements. The form is dated September 9, 2024, and must be completed and signed by an authorized representative of the vendor, including printed name, title, and date.
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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 .