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• <br /> 4 h'. <br /> _ . CONFLICT OF INTEREST <br /> V i1 <br /> City of Sunny Isles Beach <br /> • 18070 Collins Avenue <br /> • -• • Sunny Isles Beach.FL 33160 <br /> '•0. so.' 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 /> • <br /> STATE OF FLORIDA <br /> COUNTY OF Miami- Dade <br /> BEFORE ME. the undersigned authority, personally appeared Bret T. Brittenum , who was duly sworn, <br /> deposes, and states: <br /> 18.1. I am the General Manager of <br /> Academy Bus. LLC with a local office in Miami-Dade and principal office in <br /> Miami-Dade . <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: kcioc1§0ap,edoomo(Rzzgiyin. The Affiant has made diligent inquiry and provides the information contained in this <br /> Affidavit based upon his own knowledge. (Motor Coach Transportation Services) <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 /> 18.8 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 /> 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 /> Dap his day of „. . ,20119.6 <br /> A IANT Print or Type Name and Title <br /> Sworn to and subscribed before me this_7lyd day of March , 201 Q.6 <br /> Personally Known OR <br /> Produced Identification ; Type of Identifi tion <br /> 4N PUBLIC STATE OF FLORIDA <br /> "qy'o�•- ylenis Almira <br /> ® ... ' � Corn mission#EE863910 <br /> =• m ¢; <br /> ?,...w. Expires: Jan.09,2017 <br /> '•;�p�' ��� BONDED THRU <br /> '••.rnr,, Aix.NOTARY&SURETY BONDS <br /> OECEUSER 28,2010 5 of 7 S B <br />