Reso 2020-3042 - Laserfiche WebLink

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�SJNNY lStf • CONFLICT OF INTEREST City of Sunny Isles Beach 18070 Collins Avenue a •F Lop'° .' s‘ Sunny Isles Beach,FL 33160 c'*o.suti -' 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 the of anyofficer, director, partner, associate or agent who is also an officer or employee of disclose with their Bids,the name g City of Sunny Isles Beach or its agencies. STATE OF FLORIDA- COUNTY OF IL t4.0 i .D4� L .Y ( sworn, D ,f 1 who was duly BEFORE ME, the undersigned authority, personally appeared (11�0� deposes,and states: 18.1. I am the R t b T"4.1A � of office o ce_ ,. , � _ . i with a local office in QqO�0 AA") 15;)•""d . and principal in 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 19-11-192. described as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has no financial interest in other entities submitting Bids for the same project. 18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in any collusion,or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above Bid. 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 any one 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 any one 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. 18.9 In,the event that a conflict • int est is identified in the provision of services,I, on behalf of the above named entity,will immediately notify the City of y 1=s Beach. Dated this 0 •- of 1 V • r !0k1 �� 1.--� D 11-I I 0 4 J AFFIANT Print or Type Name and Title _ Sworn to and subscribe• •efore me this day of L/cts , P948� Personally Known' OR O Prpduced Identification :Type of!de tffication ` 1 NOTARY PUBLIC STATE OF FLORIDA 001laa 4,0404% b Notary Public 18ts Di ih Jamar Peon GG 924496 f fi 04,\;00012i120 23 ala+� DECEMBER 28,2010 5 of 8