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o�SVNroY isgF� <br />CONFLICT OF INTEREST <br />U T <br />City of Sunny Isles Beach <br />' 18070 Collins Avenue <br />�y o9r' F104•�vFS�r <br />P v Sunny isles Beach, FL 33180 <br />�tk at G ��' Telephone. 095) 947-0808 Fay (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 FLORID <br />COUNTY OF 41A.ib1 <br />BEFORE ME, the undersigned authority, personally appeared Yoofl Get I ctLS <br />who was duly sworn, <br />deposes, and states: <br />18.1. I am the pfaeS i.c d dV -r of <br />with a local office in M1 t; —'b4ze and principal office in <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. -7Tb 25~&°Q1described <br />as: Golden Shores Street Lighting. 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 onesubmittal 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 some 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 />16.6 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 />%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 />18.9 In the event that a conflict of interest_is identified In the provision of services, 1, on behalf of the above named entity, will <br />immediately notii heZity of Sunny Isles Beach. <br />D ate �� da f '+� 2025. <br />vv�f- mat <br />AFIANT Print or Type Name and Title <br />Sworn o and subsc bed efore me this 2fo day of '46" ' , 2025. <br />Personally Known OR <br />O Produced identification ; Type of Identill on <br />NOTARY PUBLIC STATE OF FLORIDA <br />YOHANIA CHAMIZO <br />Notary publlc-8tato of Florida <br />Commission # HH 220934 <br />My Commission Expires <br />April 18, 2026 <br />oecQ Bm28:2010 <br />