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Unique Charters, Inc.
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(16-03-01) Motor Coach Transportation
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Unique Charters, Inc.
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Last modified
3/31/2016 10:44:44 AM
Creation date
3/31/2016 10:44:43 AM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Motor Coach Transportation Services
Bid No. (xx-xx-xx)
16-03-01
Project Type (Bid, RFP, RFQ)
Bid
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y,sN♦114 es <br /> -1 n CONFLICT OF INTEREST <br /> G - z <br /> • <br /> .\ City of Sunny Isles Beach <br /> \ 18070 Collins Avenue <br /> soy I " <br /> '•• o ‘o0 s. Sunny Isles Beach,FL 33160 <br /> ,0s SOW " 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 Kris Smith who was duly sworn, <br /> deposes,and states: <br /> 18.1. I am the Operations Manager of <br /> UNIQUE CHARTERS, INC with a local office in 160 NW 176TH STREET SUITE 200-1 and principal office in <br /> 160 NW 176TH STREET SUITE 200-1 MIAMI GARDENS, FL 33169 <br /> MIAMI GARDENS, FL 33169 <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 16-03-01 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 notify the City of Sunny Isles Beach. <br /> Dated this ` 1 day of ��,.r.L.... , 2016 <br /> Kris Smith/Operations Manager <br /> AFF Print or Type Name and Title <br /> Sworn to and subscribed before me this a..C'1 day of — , 201b <br /> .1l Personally Known OR <br /> O Produced Identification :Ty dentification <br /> t <br /> NOTARY PUBLIC STATE OF FLORIDA <br /> • <br /> RICHARD A.NZERIBE <br /> NOTARY PUBLIC <br /> �dI,4 STATE OF FLORIDA <br /> _ Orme FF920222 <br /> Mourne(28.2010 5 Of 7 Expires 12/14/2019 <br />
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