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RFP No. 16-04-03 Time and Attendance System
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Last modified
5/12/2016 10:29:13 AM
Creation date
5/12/2016 10:08:18 AM
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CityClerk-Bids_RFP_RFQ
Project Name
Employee Time and Attendance System
Bid No. (xx-xx-xx)
16-04-03
Project Type (Bid, RFP, RFQ)
RFP
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MN, rt <br /> ,s �Eru, <br /> CONFLICT OF INTEREST <br /> u l Is <br /> ® '. i , . City of Sunny Isles Beach <br /> •_ 18070 Collins Avenue <br /> `r r °17::::-;7"17O—.'� o+` Sunny Isles Beach,FL 33160 <br /> ' o, sun '" 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 City <br /> of Sunny Isles Beach or its agencies. <br /> STATE OF FLORIDA <br /> COUNTY OF <br /> BEFORE ME, the undersigned authority, personally appeared Andrew Blundell , who was duly sworn, <br /> deposes, and states: <br /> 18.1. I am the President of <br /> Andrews Technology HMS, Inc. with a local office in w; 1 mi nrjtnn, NC and <br /> principal office in Wilmington. NC . <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 1 6-04-03 described as: <br /> Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this Affidavit <br /> 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 no <br /> 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 any <br /> collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the <br /> above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution <br /> 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 other <br /> clients, contracts, or property interests for this project. <br /> 18.7 I 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 of <br /> 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 /> n <br /> Dated thispp day . ``i' . , 201 <br /> C/�—�` v.w 4A pC54 U r fR 44 <br /> AFFIANT Print o ype Name and Title <br /> Sworn to and subscribed before me this /day of , 201‘ <br /> " Personally Known ✓ OR <br /> Produced Identification ; Type of Identificatiaj / <br /> moil( C4io4hr �ii--+-s�t',r--/ <br /> NOTARY PUBLIC STATE OF-FLARIDA <br /> • to"in- p>" -5412 jj S <br /> DECEMBER 28.2010 5 of 7 <br />
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