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s <br /> a <br /> ® SUNnt r4rf . <br /> O* sO <br /> ® o1 �n CONFLICT OF INTEREST <br /> ® v(`— I1 'r Y <br /> City of Sunny Isles Beach <br /> "-- • 18070 Collins Avenue <br /> ® •'s of <br /> A %e 27. F s'': Sunny Isles Beach,FL 33160 <br /> or sew'w Telephone:(305)947-0606 Fax:(305)949-3113 <br /> 0 <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 FLORIDA <br /> COUNTY OF Miami-Dade <br /> ® BEFORE ME, the undersigned authority, personally appeared Michael D. Futterman , who was duly sworn, <br /> ® deposes, and states: <br /> ® 18.1. I am the Partner of <br /> ® Marcum LLP with a local office in Miami and principal office in <br /> New York <br /> ® 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 15-12-01 described <br /> ® as: Professional Auditing 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 /> ® Dated t is 30 day of December 2015. <br /> ® AFFIA T Print or Type Name and Title <br /> to and subscribed before me this 30day of AC" Irait , 2015. <br /> 411 SwoI Personally Known OR <br /> 0 Produced Identification ;Type oinfificafion <br /> ® NOTARY PUBLIC STATE OF FLORIDA /• <br /> V v <br /> • <br /> f o s4% 'Notary Public Star of FMrioa <br /> Pasquale Pisana <br /> to. s,0 My Commission FF 087093 <br /> ^ipr wd Expires 01/2812018 <br /> 0 <br /> DECEYBER28,2010 5 of 7 <br />