Reso 2011-1665 - Laserfiche WebLink

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SECTION 18 CONFLICT OF INTEREST STATEMENT STATE OF FLORIDA COUNTY OF Dt~ (~ C -- . BEFORE ME, the undersigned authority, personally appeared c..,^ r,c...-+,'n ... ~ t *_, who was duly sworn, deposes, and states: 18.1. I am the \) \f' P S \==11\ s-."''\.I ~ (' j? ~, -::c.. L with a principal office in '17C{-, '/vl,.) '7 q Ave... ?re~\ t-le_+ local office in IU I'~ " - D... d. c" of and 18.2. The above named entity is submitting a Proposal for the City of Sunny Isles Beach, Proposal No. \0- '1- C\ described as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 18.3 The Affiant states that only one submittal for the above proposal is being submitted and that the above named entity has no financial interest in other entities submitting proposals for the same project. 18.4 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 submittal for the above proposal. This statement restricts the , discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. 18.5 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. 18.6 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. 18.1 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. 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 of Sunny Isles Beach. 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 immediately notify the City of Sunny Isles Beach. day Of~/,,:::.eI"Y} k-e I < ~ . "101,0. \:;:> c /...r ,:xHCt<< ::Z::.f.L..k. \l~" AFFIA Print or Type Name and Title / Sworn to and subscribed before me this r....3 day oZJ): r!-. e (}::JjL) e r, 2010. o Personally Known OR I \ o Produced Identification ; Type of I entificatiorr.......' :J)~ NOTARY PUBLIC STATE OF FLORIDA EILEEN DOMINGUEZ MY COMMISSION # DO 812645 EXPIRES: Augusl7, 2012 ,.' Bonded Thru Notary Public UndeJWriters ~ ~ PAGE 102 OF 105 PROPOSAL No.