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I hJ$N 11\, I Oft.--r:S..' EJ t: I o' S CONFLICT OF INTEREST I\ City of Sunny Isles Beach ppp i• 16070 Collins Avenue rc •rvo• o� Sunny Isles Beach,FL 33160 o. ,os 's Telephone:(305)947-0606 Fax:(305)949-3113 ICONFLICT OF INTEREST STATEMENT The award of any contract hereunder is subject to the provisions of C hapter 112, Florida State Statutes. Proposers must disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the 1 City of Sunny Isles Beach or its agencies. STATE OF FLQRIDA COUNTY OF Laange IBEFORE ME, the u ndersigned authority, personally appeared Daniel J. O'Keefe , who was duly sworn, deposes, and states: 118.1. I am the Shareholder of and principal office Moore Stephens Lovelace, P.A. loth a loco I office in Miami Florida in Orlando. Florida 15-12-01 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. described as: The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge rofessional Auditing Services I 18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has no financial interest in other entities submitting Bids for the same project. 18.4 Neither the Affiant nor the a bove named entity has directly or indirectly entered into any agreement, participated in 1 any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. I 18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. 18.6 Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any I other clients,contracts, or property interests for this project. 18.71 certify that n o member of the entity's ownership or ma nagement is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. I 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 of Sunny Isles Beach. I 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 immediately notify the City of Sunny Isles Beach. L n�-- this Z. 9 day of 1.0 ell".cJV 2015. 1A FIANT . e)\C Daniel J. O'Keefe. Shareholder Print or Type Name and Title Sworn to and subscribed before me this 2-9 day of L/P(e „nbir- , 2015. 1 O Personally Known OR Produced Identification ; Type of!dentin tion �l�,,,,," NOTA••• • 1 ' •- C>CS� T r T�p' `�MD i"p� 1 md" y Pudlo sale of Florida THlany s wyrn My Commission FF 210851 1.ea. Expires 04m5l2019 I DECEMBER 28.2010 5 of 7 . 1