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o`S $NY ss,, <br /> CONFLICT OF INTEREST <br /> City of Sunny Isles Beach <br /> 18070 Colons Avenue <br /> '.•, o"u ••` Sunny Isles Beach.FL 33160 <br /> o.suw' 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 J'u/i-( j-13 BEFORE ME, the undersigned authority, personally appeared VS : , who was duly sworn, <br /> deposes,and states: <br /> .1. _ I am they )e1. -p� 79';Otev1ir of <br /> we o • �, t e %' •Y with a local office in and principal office in <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. described <br /> as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this <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 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 /> 18.7 I 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 /> 18.8 I 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 /> Dated this ajrbf C Ge NAtv e~f" 201 i e AL <br /> I>C T t or Type Nam.nd itle <br /> Sworn to and subscribed before me this /(a day of 1O2t a/Ay-; , 201 of <br /> 13� Personally Known OR <br /> 0 Produced Identification ;Type of Identificati, i,a <br /> J.� <br /> NOTARY PUBLIC STATE OFD€1r,ORIDA <br /> ';•••• Et1NA REYES <br /> * _ T„ * MY COMMISSION 1 FF 054581 <br /> >u EXPIRES:November 29,2017 <br /> •l440 nay' Bated 1TirBaega Wary k, n <br /> DV:EIMER 28.2010 5 of 10 <br />