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Elite Tactical Security
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(16-04-05) School Crossing Guard Services
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Elite Tactical Security
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Last modified
5/25/2016 4:55:40 PM
Creation date
5/25/2016 4:39:59 PM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
School Crossing Guard Services
Bid No. (xx-xx-xx)
16-04-05
Project Type (Bid, RFP, RFQ)
Bid
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SUNNY,ste <br /> CONFLICT OF INTEREST <br /> . ,l' City of Sunny Isles Beach <br /> " 18070 Collins Avenue <br /> (X`OE • Sunny Isles Beach,FL 33160 <br /> "'o, sure 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 Jose Manuel Lorenzo , who was duly sworn, <br /> deposes, and states: <br /> 18.1. I am the President of <br /> Elite Tactical Security Corp. with a local office in Miramar FL and principal office in <br /> Miramar FL <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 16-04-05 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 /> 18.8 1 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 /> Date I 23 day of jL (Xy , 2010 <br /> temp Manuel I nrrn7n Pracirlant <br /> AFFI Iirr <br /> Print or Type Name and Title <br /> Sworn to and subscribed before me this day of M6\ , 20102 <br /> ❑ Personally Known OR <br /> a.---' Produced Identification ;Type of Identification'- L(.•/259. -'$gfl O( <br /> �� <br /> NOTARY PUBLIC STATE OF FLORIDA SP. <br /> JESSICA Al LEON <br /> My COMMISSION b FF960878 <br /> EXPIRES February 15.2020 <br /> 14011141L•51 norxltNnYyaavro.am' <br /> DECEMBER 28,2010 5 of 10 <br />
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