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(16-06-01) Shoreline Surveying and Mapping Consulting Services
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Olin Hydrographic
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6/28/2016 4:41:35 PM
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\n CONFLICT OF INTEREST <br />U� I= <br />City of Sunny Isles Beach <br />16070 Collins Avenue <br />v"Lo Q +4 Sunny Isles Beach, FL 33160 <br />er�Y OF S , ",,o Telephone' (305) 947-0606 Fax' {345} 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 David Olin <br />deposes, and states: <br />who was duiy sworn, <br />18.1. 1 am the President of <br />Olin Hydrographic SolUtions, InC. with a local office in jdjami-Dade Collnty and principal office in <br />Miami Dade County <br />R F Q-16-06-01-0-2016Im b <br />13.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid, No. described <br />as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this <br />Affidavit based upon his oven 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 />18.5 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 />Datday of ®� f� 7,��� f �d _ 120 <br />I r t rJ, <br />AFFIANT Print or Type Name and Title <br />Sworn to and subscribed before me thi/� day ofi°�� %� 2014 <br />Personally Known OR <br />Produced Identification ; Type of IdejAfication <br />NOTARY PUBLIC STATE OF FLORIDA <br />#0 P11� `n Notary Public State of Florida <br />Stanley Moore <br />My Commission EE 631961 <br />orrkp� Expires 09/2812016 <br />DECEMBER 28, 2010 5 of 7 <br />
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