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0 $NNYY <br /> ® / c`\ce CONFLICT OF INTEREST <br /> V1_ <br /> ® 7s.<- <br /> n City 1 70Cny Isles Beach <br /> A- 18070 Beat Avenue <br /> se ' -no•S°0 ss Sunny Isles Beach,FL 33160 <br /> ® u„on Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ® CONFLICT OF INTEREST STATEMENT <br /> ® The award of any contract hereunder is sutject 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 /> ® Morn.621/na <br /> STATE OF FLORIDA . <br /> 0 COUNTY OF yvucklenb1.[, <br /> ® BEFORE ME, the undersigned authority, personally appeared B 4 n 44 £4 prr G 141,, who was duly sworn, <br /> deposes, and states: <br /> • 18.1. I am the Presto/6g-IT If <br /> of <br /> Geer-at,:Ai Pc/k.115, Inc _ with a local office in C.k.1671tr it/c/((n td.,14 and principal office in <br /> ® (t,./(cite, /1/ct1t, 1cr-c(:ii o ///�"v�1 <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No.(& i-i-OS 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 prcject. <br /> 18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in <br /> ® <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 prcject. <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 prcject. <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,-1, on behalf of the above named entity, will <br /> ® <br /> immediately notify the City of Sunny Isles Beach. <br /> ® Dated this (t day of M 20147 <br /> 122 <br /> �� Br(/.1 4..., Aric1i 4estat,n <br /> ® AFFIANT Print or Type Nartne and Title <br /> Swo f to and subscribed before me this I% day of t"1. ,20167 <br /> ® 3- Personally Known OR <br /> O Produced Identification ; Type of Identification .. ,. <br /> ® z...kar 6V'er - Jn <br /> ® NOTARY PUBLIC STATEVF7t19Rte* 7 - T y^..3 <br /> �, <br /> •� z <br /> ® 4, -r <br /> 0 <br /> DECEMBER 28.2010 50f 10 '+.,. „Y.r`' <br />