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(14-07-02) Continuing Professional Architectural and Engineering Services - Individulas Only CCNA
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Last modified
1/7/2015 12:11:14 PM
Creation date
8/25/2014 12:00:13 PM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Continuing Professional Architectural and Engineering
Bid No. (xx-xx-xx)
14-07-02
Project Type (Bid, RFP, RFQ)
RFQ
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SuPyNT ,xrF <br />0 <br />CONFLICT OF INTEREST <br />City of Sunny Isles Beach <br />o. <br />18070 Collins Avenue <br />'.�T �no� o•' Sunny Isles Beach, FL 33160 <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 Agustin Barrera, AIA , who was duly swom, <br />deposes, and states: <br />18.1. 1 am the Vice President of <br />AECOM Technical Services, Inc. with a local office in Coral Gables, FL and principal office in <br />Los Angeles, CA <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 />18.81 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 />Dated this 8 day of August <br />AFFIAN_T � <br />Print or Type Name and Title <br />2014 <br />VS rn to and subscribed before me this U_ day of August , 2014 <br />J" Personally Known OR <br />O Produced Identification ; Type of Ident ion <br />NOTARYPU <br />•o`�^i °tee% KIMBERLY WINDLOSS- SISLER <br />®Notary Public - State of Florida <br />P My Comm. Expires Aug 3. 2017 <br />W.^'� Commission M FF 025307 <br />ry .x, <br />IXre,eae 28.2010 5 of 7 <br />
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