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(15-07-01) Citywide Custodial Services
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Last modified
10/23/2015 11:31:26 AM
Creation date
8/7/2015 11:05:48 AM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Citywide Custodial Services
Bid No. (xx-xx-xx)
15-07-01
Project Type (Bid, RFP, RFQ)
Bid
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ow. IJ<fJ <br /> CONFLICT OF INTEREST <br /> ai City of Sunny Isles Beach <br /> /01 18070 Collins Avenue <br /> •• J-•1o�1 Sunnylsles Beach,FL 33160 <br /> 0,.� Telephone:(305)947-0606 Far(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 FLO IDA <br /> COUNTY OF MA* -4{- <br /> BEFORE ME, the undersigned authority, personally appeared Enka Leal' , who was duly sworn, <br /> deposes,and states: _L <br /> 18.1.„ I arp the ?M " ' of <br /> <<^•1li. ^ r,1 - with a local &ice in Marl,Pt and principal office in <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No.g /90q-0/ 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 I 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 /> f � Dated this 60 day of r/W-'>T �0 r <br /> �J1 644 4409 Lenr1l / -t--Y'11L[r l,Cnni S crn�e-1T "fDc& -C.7U(� <br /> AFFIANT Print or Type Name and Title <br /> Sworn to and subscribed before me this r'O day of /1/y'u S r ,30,Personally Known OR / /` //11 <br /> p/ Produced Identification ;Type of Identifi tion 44 4 11V34 LC-fr)"' <br /> NOTARY PUBLIC STATE OF FLORIDA <br /> 4 <br /> d�a,, <br /> , 4 <br /> i•,:a� es; W MENESES <br /> ,E Notary Public-State of Florida <br /> N, nu '` My Comm.Expires Jul 1,2018 <br /> "48 � A Commission #FF 138149 <br /> Deeceuam n.2010 <br />
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