Laserfiche WebLink
0 <br /> ® sta. <br /> ``r <br /> St <br /> '---Azt:toe, <br /> ® CONFLICT OF INTEREST <br /> n)72V <br /> ® City of Sunny Isles Beach <br /> `_—'" ' 18070 Collins Avenue <br /> 4 -'. o <br /> 5 Fio�� o•7 Sunny Isles Beach,FL 33160 <br /> o, .us 'S Telephone:(305)947-0606 Fax:(305)949-3113 <br /> O <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 /> 0 COUNTY OF Broward <br /> ® BEFORE ME, the undersigned authority, personally appeared Shelley Eichner, AICP _, who was duly sworn, <br /> ® deposes, and states: <br /> 5 18.1. I am the Senior Vice President of <br /> ® Calvin Giordano & Associates, Incwith a local office in Fort Lauderdale and principal office in <br /> Fort Lauderdale <br /> ® 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 12-04-02 described <br /> ® as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this <br /> 0 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 /> 5 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 /> ® <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 Bee�ach. <br /> ® Dat dthis�Y� day of ( JpIAJ 201{h <br /> i �;tO LI Tie <br /> 6v. r Shelley Eichner, AICP, Senior'Vice President <br /> ® JAFFIANT r Print or Type Name and Title <br /> Svyprn to and subscribed before me this �4 day of , 201& <br /> 5 ' Personally Known OR <br /> ® 0 Produced Identification ;Type of Identification <br /> ® NOTARY PUBLIC STATE OF FLORIDA <br /> 5 MARTHA EVANS <br /> ® NOTARY <br /> COMMISSION STATE OF _ <br /> N#EE� <br /> ® EXPIRES 6/21/2014 <br /> oouoED Tall 1 b96NOTARY1 <br /> 0 <br /> DECEMBER 28,2010 5 of 7 <br />