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,'vNNY I j�E1 CONFLICT OF INTEREST 'u� z City of Sunny Isles Beach �•• �- ; "� • 16070 Corirm Avenue Sunny Ines 8eau,, FL aaiou TeWpWrre (305) eg7-uu Fax (305) ewWa 1 is CONFLICT OF INTEREST STATEMENT i ne awaM or any contract neieuraje, is subject to the provisions of Chapter 112, Florida State Statutes. Prupuburs must disclose 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. 51AIi=01- rCuRIuA COUNTY OF Miami Dade BEFORE ME, the undersigned authon'ry, personally appeareo Aida M. Curt:a yyn0 was t7ory avruin_ deposes, ana stares: 18.1. 1 am the rresdaenc or Lurtis t xogere uesign Studio, Inc. wire a tocai office in Broward r❑untj, arta prin—opal Otnce in Miam: Daae Co—t, 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No 16-(4-02 aescri4L� as: Landscape Maintenance Services. The Amant Eras mase aiiigent Inquiry Em pro.,0s me information contained in this Amaa.K MW upon Ria wnrcWwieoge. 18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above name'a entity 'las no financial interest in other entities submitting Bias for the same project. 13.4 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 submRfal for the above Bid. This statement resui= the 'discussion of pricing tiara until tRe completion of negotimma iT ucuessany and e„ ecuuon M me Contraai Tor tris p,.,iect. 18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from pafticipation in contract letting oy any local, State, or FI?8eral Hgency. 18.6 ReRIVIr me entity; nor its amiiates, nor any one associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. ii"s.T I 5Mty that no member of the entity's ownersftip ar nranayaRTent ii premrtiy applying tOr aiiy employee position or aMvely seekir rg ai i elected pos;tion with the City of Sunny Isles Beach. 18.81 certify that no member of the entity's ownership or management, or Graff has a vW0 interest In any aspeH or me CRy of Sunny Isles Beach. iux 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 the City of Sunny Isles Beach. th13 5th Of May lulu. 2016 Ar- -'��"" Print Or Type Name and Title Sworn to and subscribed before me this day of lulu. M Personally FMown urc Li Produ ea laemincaft, Type ntifi 'an �Z NOTARY PUBLIC STATE OF FLORIDA O' rosary Pubk O trr d FMWMW . sarcoma utas My t:osnmfalon FF 71ia63 mcomm4o.aro 50f /