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• <br />0 <br />O <br />0 <br />0 <br />SJN� <br />Y _��FJ <br />CONFLICT OF INTEREST <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />to +` <br />Sunny Isles Beach, FL 33160 <br />o, iu- ' <br />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 />COUNTYOF Miami -Dade <br />BEFORE ME, the undersigned authority, personally appeared Randy Hollingworth , who was duly sworn, <br />deposes, and states: <br />18.1. 1 am the Vice President of <br />Bemello Ajamil 6 Partners, Lnc. with a local office In Miami, FL and principal office In <br />Miami, r'L <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 14 - 07 - 02 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 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 />18.5 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 1 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 />Date � 'U day of 1 \, � , 20' <br />Faodv Hollinw rth - vice President <br />Print or Type Name and Title <br />� LL� I c <br />Sworn to and subscribed before me this v day of ^�qL *- _2010. <br />%' Personally Known OR <br />O Produced Identification Type of Identification N <br />I <br />iC <br />NOTARY PUBLI F.�t0 <br />EJ(PIRES: Juy 21,2015 <br />. ., ButleE tivuNWryRL6c Ltri0vrRes <br />DECEMBER 28, 2810 <br />5of7 <br />i9q <br />