Lobbyist_Registration_Affidavit_-_Group_B.pdf

144 KB Posted

Attached to
Marketing and Public Relations Services
Solicitation number
RFP0000017
Issued by
Miami-Dade County, Florida

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This is a Lobbyist Registration Affidavit – Group B form issued by Miami-Dade County for the Marketing and Public Relations Services solicitation. The affidavit is designed to authorize specific individuals to participate in oral presentations and recorded negotiation meetings or sessions before Miami-Dade County evaluation, selection, technical review committees, or subcommittees related to the procurement matter. The form permits technical experts or employees of the principal whose normal scope of employment does not include lobbying to appear at such meetings without separate lobbyist registration or payment of registration fees, in accordance with Miami-Dade County Ordinance No. 21-73 Relating to Conflict of Interest and Code of Ethics. The affidavit requires the principal to list all authorized individuals with their names, titles, employers, and email addresses on designated lines, with space for up to sixteen participants and additional sheets as necessary.

The principal's authorized representative must execute a written declaration under penalties of perjury pursuant to Florida Statute 92.525, affirming that the information provided is true, accurate, and complete. The affidavit may be amended at any time if information changes or if additional individuals are authorized to participate, with amended versions filed by County Procurement staff with the Clerk of the Board prior to the oral presentation or recorded negotiation meeting. No individual may appear before a Miami-Dade County evaluation, selection, technical review or similar committee or subcommittee unless specifically listed on the affidavit or separately registered as a lobbyist with the Clerk of the Board with all applicable fees paid.

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Form_1B_-_Price_Proposal_Schedule_-_Group_B.pdf PDF
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Lobbyist_Registration_Affidavit_-_Group_A.pdf PDF
RFP0000017_Packet_for_Solicitation_.pdf PDF
07202026_PM_RFP0000017_1_2_0_08202026_Solicitation_Packet.pdf PDF
Form_1A_-_Price_Proposal_Schedule_-_Group_A.pdf PDF
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11072022

LOBBYIST REGISTRATION AFFIDAVIT - GROUP B

(For an Oral Presentation and/or Recorded Negotiation Meeting or Sessions)

Legal Entity’s Name:

Address: City, State and Zip Code:

Business Telephone: E-mail:

Solicitation/Contract No. and Title:

Below listed individuals are authorized to participate in 1) an oral presentation before a Miami-Dade County evaluation, selection, technical review or similar committee or subcommittee, and/or 2) recorded negotiation meeting or sessions, involving the above-referenced procurement matter.

NAME TITLE EMPLOYER E-MAIL

FOR SPD’s A/E AND D/B

TEAM USE ONLY

SIGNATURE

(ATTACH ADDITIONA L S HE E TS AS NE CE S S ARY )

11072022

For the sole purpose of an oral presentation and/or recorded negotiation meeting and sessions, the listed individuals shall not be required to separately register as lobbyists or pay any registration fees, in accordance with Ordinance No. 21-73, Relating to Conflict of Interest and Code of Ethics. The Lobbyist Registration Affidavit (this Affidavit) shall list all technical experts or employees of Principal whose normal scope of employment does not include lobbying and whose sole participation involves appearance at the meeting.

No individual shall appear before a Miami-Dade County evaluation, selection, technical review or similar committee or subcommittee, and/or recorded negotiation meeting or sessions involving the above-referenced procurement matter, unless specifically listed herein or registered as a lobbyist with the Clerk of the Board and has paid all applicable fees.

Nothing contained herein shall prohibit the Principal from amending any filed Lobbyist Registration Affidavit if any information changes and/or if additional individuals are authorized (by Principal) to participate in an oral presentation and/or recorded negotiation meeting and sessions. Amended Affidavit shall be filed by County Procurement staff with the Clerk of the Board, prior to the oral presentation and/or recorded negotiation meeting or sessions.

Written Declaration: Pursuant to §92.525, Florida Statutes, under penalties of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true, accurate, and complete.

Signature of Authorized Representative (Principal):

Printed Name of Authorized Representative (Principal):

Title: Date:

https://www.miamidade.gov/govaction/legistarfiles/MinMatters/Y2021/211344min.pdf

(For an Oral Presentation and/or Recorded Negotiation Meeting or Sessions)
Below listed individuals are authorized to participate in 1) an oral presentation before a Miami-Dade County evaluation, selection, technical review or similar committee or subcommittee, and/or 2) recorded negotiation meeting or sessions, involving th...
No individual shall appear before a Miami-Dade County evaluation, selection, technical review or similar committee or subcommittee, and/or recorded negotiation meeting or sessions involving the above-referenced procurement matter, unless specifically ...
Nothing contained herein shall prohibit the Principal from amending any filed Lobbyist Registration Affidavit if any information changes and/or if additional individuals are authorized (by Principal) to participate in an oral presentation and/or recor...
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