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Cool-Breeze Air Conditioning Corp.
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(16-09-02) HVAC Government Center
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Cool-Breeze Air Conditioning Corp.
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Last modified
1/10/2017 3:01:55 PM
Creation date
1/10/2017 2:15:34 PM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
New HVAC Chiller Systems For Government Center
Bid No. (xx-xx-xx)
16-09-02
Project Type (Bid, RFP, RFQ)
Bid
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@�NN7 ysC FJ' <br />k CONFLICT OF INTEREST <br />City of Sunny Isles Beach <br />r 18070 Collins Avenue <br /><<9y F' V"V +` Sunny Isles Beach, Fl- 33160 <br />a r Sul h� 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 DADF. <br />BEFORE ME, the undersigned authority, personally appeared Frank Crawley , who was duly sworn, <br />deposes, and states <br />18.1. 1 am the President of <br />Cool -Breeze Air Conditioning Corpwith a local office in Miami, Florida and principal office in <br />Miami, FlQrida <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 16-09-()2 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 />18.81 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 hi day of-ja.t— <br />AFFIANT Print or Type Name and Title <br />_Syyetrorn to and subscribed before me this ��day of � �1`��t����� s,29'f'Q <br />N Personally Known OR <br />O Produced Identification ;Type of Ide tificatian <br />X,. <br />NOTARY PUBLIC STATE OF FLORIDA <br />NMII J SUAREZ <br />MY COMMISSION # FF -958965 <br />EXPIRES Axil 14. 2020 <br />DECEMBER 28, 2010 5 of 10 <br />440Ti�.53 rkwW&NQ4 .um^ <br />
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