Chen-Moore & Assoc. - Laserfiche WebLink

Home Browse Search

) CONFLICT OF INTEREST City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 CONFLICT OF INTEREST STATEMENT The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the City of Sunny Isles Beach or its agencies, STATE OF FLORIDA COUNTY OF Broward BEFORE ME, the undersigned authority, personally appeared Peter Moore, P.E., LEED AP deposes, and states: , who was duly sworn, 18.1. I am Chpn Moorp amI Ac;c;odatpc; Fnrt I ;:!llrlprrl;:!lp the President with a local office in Miami of and principal office in RFQ 18.2. The above named entity is submitting a Bie-for the City of Sunny Isles Beach, Bid No, 12-04-04 described as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge, RFQs 18.3 The Affiant states that only one submittal for the above .g;e.is being submitted and that the above named entity has no financial interest in other entities submitting Bids for the same project. RFQs 18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in any collusinrQ or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above ~ This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. 18.5 Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency, 18.6 Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. 18.7 I certify that no member of the entity's ownership or management is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. 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 of Sunny Isles Beach. ict of interest is identified in the provision of services, I, on behalf of the above named entity, will of Sunny Isles Beach. ....____' day of .r-H------- ,2012, Peter Moore. P.E.. LEED AP. President Print or Type Name and Title Sworn to an subscribed before me this ~ day of a<J Pe son ally Known OR o prpduced Identification ; Type of Identification April ,20'12 NOTARY PUBLIC STATE OF FLORIDA NOTARY PUBLIC-STATE OF FLORIDA "Ill'" K th J H . ~W''''' a ~ . omgan ~,~ lCompllsslOn #DD997048 '.",.....,... ExpIres: JUNE 01,2014 BONDED THHU ATLANTIC BONDING co" INe, . 'f'~~+'~',r?./2-I:J"-~~ ( j:./?-/I1 tZg IV (/I-j.o aJ2/9C1 (I,) CHI~RE &ASSOCIA TIS /IrQ N/I, 11-04-04 Design alld l'ermiWng Services /I(llre Illtramaslall'arks 7-9