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RFP No. 18-04-02 Disaster Debris Management and Removal Services
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KDF Enterprises
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Last modified
5/11/2018 3:03:13 PM
Creation date
5/11/2018 12:25:27 PM
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Template:
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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sosNYrs( CONFLICT OF INTEREST <br /> r'O 3 City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> 410 • �;F„�sr; Sunny Isles each,FL 33160 <br /> •,D➢ ••� Telephone:(305)947-0606 Fax:(305)949-3113 <br /> s' )r FLOR` <br /> /7-)" <br /> T}of SU" 'ao 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 Miami-Dade <br /> BEFORE ME,the undersigned authority, personally appeared Michael Martin <br /> who was duly sworn,deposes,and states: <br /> 1. I am the CFO of KDF Enterprises, LLC with a local <br /> office in Georgia,Texas and Alabama and principal office <br /> in 370 Mountain View Rd Springville,Alabama 35146 <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 Disater Derbris 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 /> 411 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 �j/ day of ,20 / <br /> `ti 7 9 Michael Martin, CFO <br /> AFF ANT Print or Type Name and Title <br /> p <br /> Sworn to and subscribed before me this 1 day of �"� 20F <br /> ® 0 Personally Known, OR <br /> ,roduced Identification-Type of(dent 'cation II <br /> �---' <br /> / / KIYA MARIE GRIFFIN I <br /> NOTARY PUBLIC STATE 0 - • z - — -� tinraryP��hlir_e <br /> al <br /> - - Crate(If Indiana <br /> . VanderburghCounty <br /> My Commission Expires Apr 9,2025 <br /> 5of10 a <br />
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