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<br /> 4 SUNNY IS�FJ
<br /> , CONFLICT OF INTEREST
<br /> •
<br /> X City of Sunny Isles Beach
<br /> ` 54'' 18070 Collins Avenue
<br /> st 7,F10.` s Sunny Isles Beach,FL 33160
<br /> "'p OF
<br /> no,0,0 Telephone:(305)947-0606 Fax:(305)949-3113
<br /> is
<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 0
<br /> City of Sunny Isles Beach or its agencies.
<br /> STATE OF FLORIDA
<br /> COUNTY OF Broward
<br /> BEFORE ME, the undersigned authority, personally appeared Michael L.Davis , who was duly sworn,
<br /> deposes, and states:
<br /> 18.1. I am the Vice President of
<br /> Keith and Schnars with a local office in Doral and principal office in
<br /> Fort Lauderdale . I®
<br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 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 /> •
<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 /> 0
<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 /> •
<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 this 30 day of Aped/(
<br /> ,Pe'2aL
<br /> Michael L.Davis,Vice President
<br /> AFFIANT Print or Type Name and Title
<br /> Sworn to and subscribed before me this 36 day of 40 I r2e1t.2_t4Z.
<br /> EK Personally Known OR
<br /> O Produced Identification ''^.�1•� �_
<br /> wan4EP1NNOCK /I �f' -�-/
<br /> • 5t MY COMMISSION t E13,�S �i vi '�.�::�`��sr -:�I
<br /> NOTARY PUBLIC STATE O' tit WIRES:Februarys 3,2016M
<br /> •
<br /> •
<br /> Bonded dttY
<br /> #v KEITH and SCHNARS,P.A. rl
<br /> ,,.-.„.
<br /> ,' FLORIDASBIp'LOCALFIRM
<br /> PAGE 42 REQl2-04-02
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