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I <br />CONFLICT OF INTEREST <br />Gty-of SUnnylslesBeach <br />tPt', z 1$070Collins Avenue <br />50ny Isles each; FL 3316tj <br />i�s� ar T reiephan4:t3()51997-08(LS FaM;(30Sl9d9-3.W <br />y� jr. F�p4t <br />e,rr 4`'uN Fro <br />CONFLICT OF INTEREST STATEiWENT <br />The award of any contract hereunder is subject to the prov;siom of Chapter 112, Florida Slate Statutes. Proposers <br />m;:st d;sdose with their Us, the r,a , e of any ofiit-err dirp.etar, partnerr associate of boQA11Nh0 is also an officer or <br />employee of the City of Sunny Isles Beach or its agencies. <br />STATE OF FLORIDA <br />CQUN1Y OF <br />BEFORE ME, the undersigned authority, personally appeared Steven Glenn <br />who was duly sworn, deppses, and states; <br />1, I am the Vice President of Tidal Basin Government Consulting, LLC <br />office in with a local <br />in Utica, NY and principalpffiCe <br />2. The above na;ried entity is submitting a Bid far the City of Sunny Isles Beach, Did.No_ <br />described as OlsaSe�r�errrisManlsoring5rrv,[es& Flnan[Ia1Rp{Ov2r}rAsslstznee, _ Tt,e Affiant has made ditigent <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 subrnitled and that the Aave <br />named entity has no Financial interest in other entities submitting8ids Forthe same pro-ject. <br />4. Neither the A6fian: nor this above named entity has directly or indire ctf enterpd into an are Y Y agreement, <br />partlelpated in any collusion, or {otherwise taken any action in restraints of tree competitive pricing In canne[tfon <br />with the entity's submittal For the above Bid. Thls statement restricts the discussion of pricing data until the <br />completion of negotiations iF necessary and execvl.ion of the Contract for thla project. <br />5: Neither; the enfty nor its affiliate;, nor anyone associated with therm,, is prGspntjy suspended or <br />otheewise ineligible from participation in contract lettirlg by any local, State, or Federal Agency. <br />G. h#eitlier th'e entity, nor its aiTiliateSr near anyone assotii3ted with illem have any pratential Conflict <br />of intgrest dueto any,ather Clients, contracts, or property interests for this project <br />7. I certify that no member oFthe entity'sown ership or managarne+lt Is presently applying for any <br />employee position or aOfvely seeking an elected position with the City of Sunny Isles Beach. <br />R_ 1 certify that no member of the entitys ownership or management, or staFf has a vested interest in any <br />aspect of the City of Sunny Isles Beach, 4 <br />7; 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 notik the City of Sunny tsles Beach, <br />Dated this day of 213 J � • <br />Steven d!ann, lice President <br />AMANT Print or Type Narine and Title <br />Swam to and subscribed befere methis E day of _ 20) <br />M�Personally Known, OR <br />Ct Produted Idaii -,ifitation -Type of Idon t1ficatiori <br />NGTARY AU8LIC STATE OF 4 <br />CRIANNA L, MO1CLRt <br />Natary MR in ih: 91a1y 4f Mow yolk S of 10 ' <br />ChaaliliedIhOneida caggly0jM' �4g� <br />Mp �am,�lssion y�pueSC12G. �'3; i�t� <br />