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RFP No. 18-04-02 Disaster Debris Management and Removal Services
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Last modified
5/11/2018 1:57:44 PM
Creation date
5/10/2018 3:33:08 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Disaster Debris Management
Bid No. (xx-xx-xx)
18-04-02
Project Type (Bid, RFP, RFQ)
RFP
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SJNNv rS�F CONFLICT OF INTEREST <br /> 1 F <br /> City of Sunny Isles Beach <br /> '^Yc c 18070 Collins Avenue • <br /> Sunny Isles each,FL 33160 <br /> r•••��= r Telephone:(305)947-0606 Fax:(305)949-3113 <br /> L 0 O P <br /> 5.P <br /> •F. 0.‘ 54, <br /> P �C,Tr OF SUN PNO <br /> CONFLICT OF INTEREST STATEMENT <br /> The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers <br /> must disclose with their Bids,the name of any officer,director, partner,associate or agent who is also an officer or <br /> employee of the City of Sunny Isles Beach or its agencies. <br /> STATE OF FLORIDA <br /> COUNTY OF Sarasota <br /> BEFORE ME,the undersigned authority, personally appeared Tia Laurie <br /> who was duly sworn,deposes,and states: <br /> 1. I am the Corporate Secretary of Ceres Environmental Services, Inc. with a local <br /> office in Sarasota,Florida and principal office <br /> in Sarasota,Florida <br /> 2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 18-04-02 <br /> described as Disaster Debris Management and Disposal Services . The Affiant has made diligent <br /> inquiry and provides the information contained in this Affidavit based upon his own knowledge. <br /> 3. The Affiant states that only one submittal for the above Bid is being submitted and that the above <br /> named entity has no financial interest in other entities submitting Bids for the same project. <br /> 40 4. Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, <br /> participated in any collusion,or otherwise taken any action in restraints of free competitive pricing in connection <br /> with the entity's submittal for the above Bid. This statement restricts the discussion of pricing data until the <br /> completion of negotiations if necessary and execution of the Contract for this project. <br /> 5. Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or <br /> otherwise ineligible from participation in contract letting by any local,State,or Federal Agency. <br /> 6. Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict <br /> of interest due to any other clients, contracts,or property interests for this project. <br /> 7. I certify that no member of the entity's ownership or management is presently applying for any <br /> employee position or actively seeking an elected position with the City of Sunny Isles Beach. <br /> 8. I certify that no member of the entity's ownership or management,or staff has a vested interest in any <br /> aspect of the City of Sunny Isles Beach. <br /> 9. In the event that a conflict of interest is identified in the provision of services, I,on behalf of the above <br /> named entity,will immediately notify the City of Sunny Isles Beach. <br /> Dated this 7th day of May 20 18 <br /> Tia Laurie, Corporate Secretary <br /> AFFIANT Print or Type Name and Title <br /> Sworn to and subscribed before me this 7th day of May 20 18 <br /> • Personally Known,OR <br /> ❑ Produced Identification-Type of Identification N/A <br /> AP <br /> NOTARY PUBLIC STATE OF FLORIDA 1 i r`••: ' 0- �; — . <br /> Z S ZAN DUNLOP <br /> . =_, ;o. Notao ' ic-StateofFlorida <br /> 5 of 10 Coryfission 9 GG 134833 <br /> My Comm.Expires Aug 15,2021 <br /> ..�... Banded through National Notary Assn. <br />
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