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yVKiN^+ALF <br />=' CONFLICT OF INTEREST <br />n <br />uII ,s <br />' 1 City of Sunny Isles Beach <br />•� 16070 Collins Avenue <br />i. �y9' f Lo*'°� �` Sunny Isles Beach, FL 33160 <br />{ a au*• ' Telephone; (305) 947-0806 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 agentwho is also an officer or employee of the <br />City of Sunny Isles Beach or its agencies. <br />STATE OF FLORIDA <br />COUNTY OF Seminole <br />BEFORE :ME, the undersigned authority, personally appeared Jim Long , who was duly sworn," <br />deposes, and states., <br />18.1. 1 am the Chief Executive Officer of <br />EnviroWaste Services Group, Inc. with a local 'office in Miang-Dade County and principal office in <br />1Ann1 Old c1 iflar nazi _ Suite 643 Palmetto Bay, FL 33157 <br />18.2. The above named entity is submitting a Bid for the City of Sunny isles Beach, Bid No. ITB 25-11-01 described <br />as (Golden Stiores Street Lighting. The Affiant has made diligent inquiry and provides the information contained in thin <br />Affidavit based upon his own knowledge. <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 (n <br />any collusion, -of 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 presenby 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 />18.91n 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 />Dated t is `9th y�of December 2024. <br />x Jim Lona. CEO <br />AFF( Print or Type Name and Title <br />Swprn to and subscribed before me this 9th day of December . 2024; <br />(�' Personally Known OR <br />O Produced Identification ; Type of Identification <br />NOTARY PUBLIC STATE OF FLORIDA �RindR 2301297 <br />0ISNe <br />JOHNF. RREHARTNotaryPubflc <br />StateofFlorlda <br />Coffml#HH361297 <br />WCEF.xplres$AIW <br />DECEMBER 2H, 2010 <br />29 <br />