Laserfiche WebLink
Conflict of Interest Statement <br />CONFLICT OF INTEREST <br />City of Sunny Isles Head, <br />• teoacr now. <br />TrWww,w: l]m) sr)deOG Fne: (306) arli <br />CONFLICT OF INTEREST STATEMENT <br />The award of any convact hereunder a subject 10 the Provisroru of Chapter 112. Florida State Statutes. Proposers must <br />disclose with Their Bids, the name of any officer. dvector, learner, associate or agent who is also an officer or employee of the <br />City of Sunny Isles Beam a is agencies. <br />STATE OF FLORIDA <br />COUNTY OF L "''� ` I ✓ , J z- <br />BEFORE ME. the undersigned authority, personalty appeared who was duty swam, <br />deposes, and states,' q�) , //��' ,p {� <br />1 &1. j� / awl- y f `� "I d/ +�/'Y/� V l7 1� A4 a <br />i! �7` lX wind a local Deice ' ._Q 1, Jl Dal alica m <br />III The above named entity is subnaeng a Bid for the City a Sunny Isles Beach, Bid No. ' S v0_� _6? scriblad <br />— Landscape Maintenance Services. The Alfiant has made d'figent inquiry and pmvdes the nfomabor, contacted in this <br />AAkUNd based upon his own knowledge. <br />1&8 The Alfiant states that Orly one submittal for the above 8d is being submhed and that the above named entity, has <br />ro flrtanfaist interest in Other enmias ubmimng Bids for Me same protect_ <br />1 &4 Neither he Afaam nor the above named entity has directly or indirectly entered into any agreement. Participated in <br />eny collusion, or otherwise taken any action in rwn ms Of free conpeoWe pncng in connection wan the entry's submittal for <br />the above herd. This statement resmics the discussion of pricing data undid he comPleton of negotahons it necessary and <br />eaecuuon Of me Contract for this protect. <br />1 8.5 Neither the entity, nor its aeiliere& nor any one associated oath them, is Presently suspended or otherwise ineligible horn <br />Partic Pason in contract letting by any local. State, or Federal Agency. <br />1&6 Neither the entry, nor its atikates, not any one associated wih them have any potential conflict of interest due to any <br />Other clients, contracts, or property interests for this protect <br />18.71 tardy that m member of the entry's ownership or management IS Presently applying for any employee position or <br />actively seeking an elected position with ne City of Sunny Isles Beam. <br />1 &81 certsy 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 Beech. <br />1&91n the event that a conflict of interest 15 identified n the provision of services_ L On behaa of the above named entity, .11 <br />immediately notify the City of Sunny Isles Beath. <br />Called day a OcirvPOt 201e5— <br />A s1-1 .� v)J rQQcw�y� Punt a T ype Name and Title <br />/1 <br />Salim tO ands bsc bed befue me Ow rTv day a A / 1 21) <br />O Personally Known OR .. <br />", Produced Identification ; Type of Identification ,Li I' i U12 / l ( 'Vf1 S <br />NOTAioppu4tlC STA <br />+ T AOU mOU <br />,. MY COMMISSION 0 FF 103501 <br />EXPIRES: March 18, 2072 <br />Bonded fire Bu* Notary Senkes <br />urawn a. tine <br />5of 7 <br />/& /Spies <br />F <br />