AFFIDAVIT OF MIAMI-DADE COUNTY

LOBBYIST REGISTRATION FOR ORAL PRESENTATION

1) Project Title:______

2) Department: Miami-Dade County Tourist Development Council

3) Firm/Proposer’s Name:______

Address:______Zip:______

4) List all Members of the Presentation Team Who Will Be Participating in the Oral Presentation:

NAME TITLE EMPLOYER PHONE

______

______

______

______

(Attach additional sheet if necessary)

The individuals named above are Registered and the Registration Fee is not required for the Oral Presentation ONLY. Proposers are advised that any individual substituted for or added to the presentation team after submittal of the proposal and filing by staff, MUST register with the Clerk of the Board and pay all applicable fees.

Other than for the oral presentation, Proposers who wish to address the County Commission, a County Board or County Committee concerning any action, decision or recommendation of County Personnel regarding this solicitation MUST register with the Clerk of the Board (Form BCCFORM2DOC) and pay all applicable fees.

I do solemnly swear that all the forgoing facts are true and correct and I have read or am familiar with the provisions of Section 2-11.1(s) of the Code of Miami-Dade County as amended.

Signature of Authorized Representative: ______Date: ______

Printed Name: ______Title: ______

STATE OF :

COUNTY OF:

The foregoing instrument was acknowledged before me this ______day of ______, ______(year),

by ______, ______

(Sole, Corporation or Partnership)

who is (personally known to me) or who has produced ______as identification and who

(did , did not) take an oath.

______

(Signature of person taking acknowledgement) (Name of Acknowledgement typed, printed or stamped)

ORAL PRESENTATION

All proposers are advised that in accordance with Section 2-11.1(s) of the Code of Miami-Dade County , FL, the Lobbyist Registration for Oral Presentation Affidavit, Must be completed, notarized and included with your proposal submission. Lobbyist specifically includes the principal, as well as any agent, officer or employee of a principal, regardless of whether such lobbying activities fall within the normal scope of employment of such agent, officer or employee.

Individuals substituted for or added to the presentation team after submittal of the proposal and filing by staff, Must register with the Clerk of the Board and pay all applicable fees.

NOTE: Other than for oral presentations, Proposers who wish to address the County Commission, County Board or Committee concerning any actions, decision or recommendation of County Personnel regarding this request for proposal must register with the Clerk of the Board (Form BCCFORM2DOC) and pay all applicable fees.