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0 <br /> 0 <br /> el <br /> ''VMS,',I If <br /> ® `, <br /> _vitiva���yy�I CONFLICT OF INTEREST <br /> �T(/ City of Sunny Isles Beach <br /> ® 7. 18070 Cones Avenue <br /> ,'f o��♦: Sunny Isles Beath.FL 33160 <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 /> I City of Sunny Isles Beach or its agencies. <br /> ® STATE OF FLORIDA <br /> ® COUNTY OF Dade <br /> ® BEFORE ME, the undersigned authority. personalty appeared Aida M. Curtiswho was duly sworn, <br /> deposes,and states: <br /> O 18.1. I am the President 11 of <br /> Curtis + Rogers Design with a local office in32SU Mary Street,SLe• anrindpal office in <br /> ® • Coconut Grove Fl . 33133 <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 /> 0 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 /> 0 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 /> O 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 /> 0 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 notify the City of Sunny Isles Beach. <br /> O D lthis 27 of i. ,2o3):0 2 <br /> ® t A�AF T�� � ,, Aida M. Curtis. President <br /> Print or Type Name and Title <br /> �"� � <br /> ® Sworn to and subscribed before me this 2-7 day of ^7''"'• ,20 I <br /> N Personally Known OR <br /> 0 Produced Identification ;Type of Identification�� / �/L/� <br /> O / Y1IM/.�I btu ! 'r/'�I e,,,,.41 <br /> ® NOTARY PUBLIC STATE OF FLORIDA Or <br /> sowy Pica Sas Of Soca <br /> P my alda Fernandez <br /> A <br /> my Cern Hann FE 157aM <br /> ® �► Eq kU 01117Rd1e <br /> O oecavnam.2010 Sof 7 <br /> 0 <br /> 0 <br /> 0 <br /> 0 <br /> O Curtis + Rogers Design Studio RFQ 12-04-02 51 <br />