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NON -COLLUSION STATEMENT <br />By signing this offer, the vendor/contractor certifies that this offer is made independently and free <br />from collusion. Vendor shall disclose below any City of Fort Lauderdale, FL officer or employee, or <br />any relative of any such officer or employee who is an officer or director of, or has a material <br />interest in, the vendor's business, who is in a position to influence this procurement. <br />Any City of Fort Lauderdale, FL officer or employee who has any input into the writing of <br />specifications or requirements, solicitation of offers, decision to award, evaluation of offers, or any <br />other activity pertinent to this procurement is presumed, for purposes hereof, to be in a position to <br />influence this procurement. <br />For purposes hereof, a person has a material interest if they directly or indirectly own more than 5 <br />percent of the total assets or capital stock of any business entity, or if they otherwise stand to <br />personally gain if the contract is awarded to this vendor. <br />In accordance with City of Fort Lauderdale, FL Policy and Standards Manual, 6.10.8.3, <br />3.3. City employees may not contract with the City through any corporation or business entity <br />in which they or their immediate family members hold a controlling financial interest (e.g., <br />ownership of five (5) percent or more). <br />3.4. Immediate family members (spouse, parents, and children) are also prohibited from <br />contracting with the City subject to the same general rules. <br />Failure of a vendor to disclose any relationship described herein shall be reason for <br />debarment in accordance with the provisions of the City Procurement Code. <br />NAME <br />RELATIONSHIPS <br />In the event the vendor does not indicate any names, the City shall interpret this to mean that <br />the vendor has indicated that no such relationships exist. <br />Authorized Signature <br />Name (Printed) <br />Title <br />Date <br />CAM #23-0426 <br />Exhibit 1 <br />Page 34 of 43 <br />