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son NY t:Lei f CONFLICT OF INTEREST ® r V I• - t t •• :/ • City of Sunny Isles Beach • Y 18070 Collins Avenue ‘"•Y r•• ,t o•'0•�•• Sunny Isles Beach,FL 33160 r o. sun'� Telephone:(305)947-0606 Fax:(305)949-3113 CONFLICT OF INTEREST STATEMENT The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must disclos?with their Bids, the name of any officer director, partner, associate or agent who is also an officer or employee of the City of Sunny Isles Beach or its agencies. 'to the best of its knowledge STATE _L ORIDA Commonwealth of Massachusetts COUNTY OF Middlesex BEFORE ME, the undersigned authority, personally appeared ---1 41(1 // 6✓1gill , who was duly sworn, deposes, and states: 18.1. I am the Senior Vice President, Global Sales of Kronos Incorporated with a local office in Miramar, FL and principal office in Chelmsford,MA 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 16-04-03 described as: .' The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 'Employee Time and Attendance System 18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has no financial interest in other entities submitting Bids for the same project. 18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in ® any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. 18.5 Neither the entity nor its affiliates;nor any one associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. 'to the best of its knowledge,any of 18.6 Neither the entity, norits affiliates, nor any one associated with them have any potential conflict of interest due to any other clients,contracts,or property interests for this project. 'to the best of its knowledge,any of 18.71 certify•that no member of the entity's ownership or management is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. 'to the best of its knowledge 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 of Sunny Isles Beach. 'to the best of its knowledge 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 immediately notify = ity of Sunny Isles Beach. Dat�i7/Lb �_ May 2040.2016 _ _ John O'Brien,Senior Vice President,Global Sales AF/FI•.•'` Print or Type Name and Title Om to a • . / ed before me this 7 day of Y(' 7ct,' ,2049.2016 Pers. Known OR 0 Produced Identification ;Type of I tification I a NOTARY PUBLIC STATE-Cif-FLORIDA Commonwealth of Massachusetts DEBORAH I.. HENDERSON Public 411 uCOMMONWEALTHOF MASSACHUSETTS My Commission Expires a _Ad/ 30, 2021 ` DEcEMSER 2e,2010 5 of 7