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�QQ SVNNY I S(v <br />_ CONFLICT OF INTEREST <br />V? _ <br />City of Sunny Isles Beach <br />r <br />18070 Collins Avenue <br />tiF DD'+ FLOR o 5° Sunny Isles Beach, FL 33160 <br />s'J Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />CONFLICT OF INTEREST STATEMENT <br />The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must <br />disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the <br />City of Sunny Isles Beach or its agencies. <br />STATE OF FLORIDA <br />COUNTY OF Miami -Dade <br />BEFORE ME, the undersigned authority, personally appeared Hugo E. Soto, P.E. , who was duly sworn., <br />deposes, and states: <br />18.1. 1 am <br />Terracon Consultants, Inc. <br />Olathe, KS <br />the <br />Principal, Office Manager of <br />with a local office in Miami Lakes and principal office in <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. RFQ No. 20-10-01 described <br />as: The Affiant has made diligent inquiry and provides the information contained in this <br />Affidavit based upon his own knowledge. Professional Engineering& Architectural Services for Pedestrian Bridge with <br />Park Elements Across AIA at 174th St. CC NA <br />18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has <br />no financial interest in other entities submitting Bids for the same project. <br />18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in <br />any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for <br />the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and <br />execution of the Contract for this project. <br />18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from <br />participation in contract letting by any local, State, or Federal Agency. <br />18.6 Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any <br />other clients, contracts, or property interests for this project. <br />18.71 certify that no member of the entity's ownership or management is presently applying for any employee position or <br />actively seeking an elected position with the City of Sunny Isles Beach. <br />18.81 certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City <br />of Sunny Isles Beach. <br />18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will <br />immediately notify the City of Sunny Isles Beach. <br />Date tis 17t day of November 2020. <br />✓ Hugo E. Soto, P.E., Principal, Office Manager <br />AFFIANT Print or Type Name and Title <br />Sworn to and subscribed before me this 17th day of November <br />0 Personally Known ✓ OR <br />O Produced Identification Type of Identification <br />NOTARY PUBLIC STATE OF FLORIDA <br />2020. <br />SUSANA DELGADO <br />State of Florida -Notary Public <br />� c Commission # GG 240244 <br />My Commission Expires <br />DECEMBER28,2010 a <br />-234- <br />