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(12-04-02) Professional Architectural and Engineering Services - Firms Only
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Coastal Systems
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Last modified
2/3/2016 4:49:21 PM
Creation date
2/3/2016 4:49:21 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Professional Architectural and Engin. Svcs
Bid No. (xx-xx-xx)
12-04-02
Project Type (Bid, RFP, RFQ)
RFQ
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' $NYIt\ <br /> Ox . O <br /> �G 19,0 ,E CONFLICT OF INTEREST <br /> City of Sunny Isles Beach <br /> •• 18070 Collins Avenue <br /> "'•r s o.o •• Sunny Isles Beach,FL 33160 <br /> ei'•or so.•1.9 <br /> Telephone:(305)947-0606 Fax:(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 FLORIDA <br /> COUNTY OF Miami-Dade <br /> BEFORE ME, the undersigned authority, personally appeared R. Harvey Sasso , who was duly sworn, <br /> deposes,and states: <br /> 18.1. I am the President of <br /> Coastal Systems International, Inc.with a local office in Coral Gables and principal office in <br /> Coral Gables <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 /> 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 /> 18.81 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 n• ify the City of Sunny Isles Beach. <br /> 12 <br /> Daley • 27 d of April , 2010. <br /> �T � resi ent <br /> AFFI•N ' • arvey Sasso Print or Type Name and Title <br /> 12 <br /> Sworn to and subscribed before me this 27 day of A.r 1 010. <br /> O Personally Known OR <br /> I ,� ' I <br /> O ProducedcedIdentification ;Type of I.-ntif� on <br /> NOTARY PUBLIC STATE OF FLORIDA van -5 a ` <br /> - ac -do <br /> ® 00.0 Mk. Notary Pudic State or Florida <br /> . Vanessa Rossi-Machado <br /> 7 • a My Commission EE017222 <br /> 1.7 oi <br /> DECEMBER 28,2010 50(7 t`0C Expires 10/14/2014 <br />
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