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.�'yJ�r`fi,!, . <br /> W 1_ <br /> CONFLICT OF INTEREST <br /> : City of Sunny Isles Beach <br /> 16070 Camra Avenue ury <br /> '•C r • <br /> c •` Sry Iles Beach.FL 33150 <br /> e•.vs•le Telephone(305)947-0606 Far.(335)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 CA <br /> COU O <br /> BEFORE ME, the undersigned authority, personally appeared Dennis Peters who was duly sworn, <br /> deposes,and states: <br /> 18.1. I am the President and CEO of <br /> IntellTme Systems Corporation with a local office in N/A and principal office in <br /> Santa Ana CA <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 16-04-03 described <br /> as: Employee Tine and Attendance System. 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,contracle,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 i - • member of 0-- entity's ownership or management, or staff has a vested interest in any aspect of the City <br /> of Sunny Isles :-- • . <br /> 18.9 In the eve • - •nflie • int ‘• Is identified in the provision of services, I, on behalf of the above named entity,will <br /> Immediately n• . •.. es Beach. <br /> Dat-• tO <br /> d1y 2016. <br /> Dennis Peters President end CEO <br /> AFFIANT Print or Type Name and Title <br /> Sworn to and subscribed before me this 15th day of April 2016. <br /> ❑ Personally Known OR <br /> O Produced Identification J ;Type of I ntifi tion Driver's Lice se <br /> NOTARY PUBLIC STATE OF IDA[_ Q <br /> /FcMif A I i� <br /> ®' l- <br /> pECe10ER M,2010 5 of 7 <br />