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. SECTION 19 CONFLICT OF INTEREST STATEMENT STATE OF FLORIDflr. ' 'd COUNTY OF 1-'1 C<"~ L~ (c-Cq~-,~ ~ JiL , who BEFORE ME, the undersigned authority, personally appeared was duly sworn, deposes, and states: () 19',1. k. I ~ am_.the r~C>> -,;;;j ~ ~f'~ 1..-A witl1 a local office in J..lIl -, pi.. principal office in ~ ,.....J Pc \ 19.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 07-10-04 described as: Landscape Maintenance Services. of and 19.3. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 19.4. 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. . 19.5. 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 pridng data until the completion of negotiations if necessary and execution of the Contract for this project. 19.6. Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. 19.7. Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. 19.8. I 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. 19.9. I 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. 19.10. In the event that a conftict 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. Da~e9__1t1hi5, "i G:. d_ay of l).JI ell" Iu~ ,2007. ~ _ flZ~~,j()t:,vJ- AFAANT Print or Type Name and TItle S~om to and subscribed before me this ~ day of '71- (' l J'.Jw------ , 2007. ~ Personally Known OR o Produced Identification ; Type of Identification . NOTARY PUBllC STATE OF /;;a~ NOTARY PUBUC-STATE OF FLORIDA ~..""U'",, Kurt V. Ingram ~ W ~ Commission # DD723885 ;.,~.! Expires: OCT. 19,2011 BONDED THRU ATLANTIC BONDING CO., INC. PAGE 89 OF 92 BID No. 07-10-04