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0014 Isr s <br />n CONFLICT OF INTEREST <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />nscPs Sunny Isles Beach, FL 33160 <br />of Suit Nc a Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />CONFLICT OF INTEREST STATEMENT <br />The <br />award of any <br />contract hereunder is subject to the provisions of Chapter 112, Florida <br />State Statutes. Proposers must <br />disclose with their <br />Bids, the name of any officer, director, partner, associate or agent who is <br />also an officer or employee of the <br />City <br />of Sunny Isles <br />Beach or its agencies. <br />STATE OF FL RIDA <br />COUNTYOFWkryl qeLLCJn <br />n <br />BEFORE ME, the undersigned authority, personally appeared ,DiF �'� *Cc (*A K< ` 4Q'%ho was duly sworn, <br />deposes, and states: <br />18.1. 1 am the of <br />V 1 r y> Se L, { . N i ({with a local office in "Kill a . lr. and principal office in <br />1ro�.► (,.trs <br />18.2. The above named entity Is submitting a Bid for the City of Sunny Isles Beach, Bid No. 02' 0 described <br />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 <br />18.4 Neither the Aifiant nor the above named entity has directly or indirectly entered Into any agreement, part <br />above <br />Bid is being submitted and <br />that the above named entity has <br />no financial interest in other entities submitting Bida for the <br />same <br />project. <br />icipated in <br />any collusion, or otherwise taken any action in restraints of free competitive pricing In connection wlihthe 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, 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 />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 <br />of Sunny Isles Beach. <br />18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will <br />immediately notify the City of Sunny Isles Beach. <br />this 2 Q day of 2019. <br />Print <br />Swyrn to and subscribed before me this � day of °1"� i�iJr l..l , 2019. <br />Personally Known OR <br />0 Produced Identification Type of Identification <br />NOTARY PUBLIC STATE OF FLORIDA <br />iii'rire.�..• AMY LYNN WITKOWSKI <br />,, <br />' �:•; Nulary Puhll-Slue afFlarida <br />z �, j�J 't;; s 1B 1673 <br />YCOMM,siunNGG <br />*?„(nl?.I My Cam Expires Feb I, 2622 <br />""'"` 1iaul vt through National NutaryAssn. <br />aECEa13ER28,2016 <br />