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/If <br />`SVNNY <br />FI <br />a; A_ <br />CONFLICT OF INTEREST <br />V <br />City of Sunny Isles Beach <br />or �I <br />9 <br />16070 Collins Avenue <br />'•ri o*x <br />Sunny Isles Beach, FL 33160 <br />o•` <br />"1 o. 1VM <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 />COUNTY OF Miami -Dade <br />BEFORE ME, the undersigned authority, personally appeared Ignacio Serralta who was duly sworn, <br />deposes, and states: <br />18.1. 1 am the President of <br />SRS Engineering, Inc. with a local office in N/A and principal office in <br />Miami <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 />t 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 />' 18.81 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, I, on behalf of the above named entity, will <br />' immediately notify the City of Sunny Isles Beach. <br />Da d thi 12 of August , 201)t <br />x. Ignacio Serralta, president <br />AF IA Print or Type Name and Title <br />Swam to and subscribed before me this 12 day of August . 201 )f4 <br />A Personally Known X OR <br />t O Produced Identification ; Type of Identification <br />Ralph A. Pereda <br />NOTARY PUBLIC STATE OF FLORIDA <br />' RALPH A. PEREDA <br />As MY 310N S EElelbip <br />r.C1j s' <br />EXPIRES Ally 23.2016 <br />CECEr 828.2010 5 of 7 <br />