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Y SJtANY rs�Ff <br />`e9 CONFLICT OF INTEREST <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />so"Sunny Isles Beach, FL 33160 <br />c`'* or suµ " Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />CONFLICT OF INTEREST STATEMENT <br />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 />STATE OF FLORIDA / <br />COUNTY OF �,j�� <br />BEFORE ME, the undersigned authority, personally appeared ffl< L.l gbE— , who was duly sworn, <br />deposes, and states: <br />18.1. 1 am the V,6401 -of <br />10EUA 6&3 with a local office in 4044d,_7 and principal office in <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, RFQ No. 20 ' 07— D described <br />as: RFQ Professional services. The Affiant has made diligent inquiry and provides the information con ained 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 />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 />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 />18.6 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 />18.81 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 />18.91n the event that a conflict of interest is identified in the provision of services, 1, on behalf of the above named entity, will <br />immediately notify the City of Sunny Isles Beach. <br />7,1W n <br />►viA-fL1L L,MVS� <br />this_ / f day of 2020. <br />or Type Name and Titlbj ,Z- <br />d <br />Sworn P and subscribed before me this _a_ day of a /, l� 4cy _ .2020. <br />O / Personally Known OR t <br />Produced Identification ;Type of Identification F-Lt2210A <br />NOTARY PUBLIC STATE OF FLORIDA <br />Q fIM111N <br />+9'� IBtrllt•o1FID11d11 <br />�.#Ay Oonrntsr�bn B4+�e� 081bAl2D28 <br />�a� 't;OirNninlonW0.ft0910181 <br />DECEmsER28,2010 <br />