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1 SUNNY IS(F <br />I <br />CONFLICT OF INTEREST <br />1 V <br />•• � � City of Sunny Isles Beach <br />18070 Collins Avenue <br />''r or�'•rto ^�o +` Sunny Isles Beach, FL 33160 <br />Telephone: (305) 947 -0606 Fax: (305) 949 -3113 <br />CONFLICT OF INTEREST STATEMENT <br />1 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 />1 STATE OF FLORIDA <br />COUNTY OF Broward <br />1 BEFORE ME, the undersigned authority, personally appeared Rene L. Castillo who was duly sworn, <br />deposes, and states: <br />18.1. 1 am the President of <br />1 Ric -Man International, Inc with a local office in Miami Beach and principal office in <br />Pnmllann Reach . <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 13 -08 -01 described <br />1 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 />1 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 />1 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 />1 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 />1 other clients, contracts, 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 />1 18.81 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 />1 18.91n the event that a conflict of interest is identified in the pr ision of s. , o behalf of the above named entity, will <br />immediately notify the o Sun y Isles Beach. <br />Dated s y of September , zoHDi: 13. <br />1 Rerfe L Castill(2. President <br />AFFIA Trinl or Type Name and Title <br />worn to and subscribed before me this 4 day of September , 20XX 13 <br />1 O Personally Known X OR <br />O Produced Identification Type entifcalion <br />C-A_n�_ A-J)-,U6;E <br />1 <br />F <br />NOTARY PUBLIC STATE OF FLORIDA <br />1 DEceu 28,2010 <br />9V <br />•...p: =�a•. <br />MARCIA VIE ST <br />Notary Public • Stale of Florida <br />My Comm. Expires May 4, 2015 <br />Commission # EE 30593 <br />9V <br />