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ATLANOV, LLC <br /> PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO.16-03-01 <br /> Dispute Disclosure <br /> Www r„ <br /> DISPUTE DISCLOSURE <br /> City of Sunny Isles Beach <br /> ' ^ stoic Cans 1*N'LY <br /> nun]eats Pack-L 33163 <br /> e.,. Tas.bne 1335)3:QDS Gat 1rs)3=33t 13 <br /> DISPUTE DISCLOSURE FORM <br /> Answer the following questions by placing a "X"after"Yes"or'NC. If you answer Y&, please <br /> explain in the space provided,or on a separate sheet attached to this form. <br /> 19.1. Has your fin or any of its offices, received a reprimand of any nature or been suspended by the <br /> Department of Profe tonal Regutatiors a any other regulatory agency a professional associations within the last <br /> five(5)years? <br /> Y6 NO X <br /> 19.2. Has your firm, or any merba of your firm, been dedared in default, thrninated or removed from a <br /> contract a job related to the services your firm provides in the regular can of bums within the last five(5) <br /> years? <br /> YE NO X <br /> 193. Has your firm had against it a Poal any request for equitable adjustment,contract claims, Bid protests, <br /> or litigation in the past five (5) years that is related to the service;your fum provide; in the regular can of <br /> bu S nes? <br /> YES NO X If yes, state the nature of the request fa equitable adjuustment, ca Bract <br /> claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the <br /> =retry amount of extended contract time involved. <br /> I hereby catty that all statement; made are true and agree and understand d that any misstatement or <br /> mvepreentation of falsification of facts shall he cause for forfeiture of right for further carideraton of this Eld <br /> for the City of army Isles Beach. <br /> Atlanov, LLC 03/30/2016 <br /> Frrn / Date <br /> /'%7, <br /> As Denis Atlanov,CEO and President <br /> Aust aced 4.41 Print or Type Name and Title <br /> 14 <br />