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SECTION 19 CONFLICT OF INTEREST STATEMENT STATE OF FLORIDA1)~ COUNTY OF 'lVC g{\lel[(. Sbt leJ- , who BEFORE ME, the undersigned authority, personally appeared was duly sworn, deposes, and states: 1~. t. rvYi ~ . ar12- the 6,q. I ()CQ M1C principal office in bM1r V lee {[ES\[)U'J\ with a local office in If)I1CC, of and 19.2. N\ -Nn-.tL The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. described as: Janitorial Maintenance Services. 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 pricing 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 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. r-i' Ju~ 2l{~ day of 2oof~ Dated this AFFIANT Sworn to and subscribed before ~s o Personally Known o Produced Identification Print or Type Name and Title J I./r'^day of ~ "" <-- OR ; Type of Identification , 200rt@ 0' ell t7e ~\k. J NOTARY PUBLIC STAT .i....':A~r~, OLGUINE VAVAl. f~/'Ji.'~ :*~ MY COMMISSION # DO 3291~4 . W~~:~"! EXPIRES: June 15, 20 ." ,c ~".:."r!f.:fr~"" BondedThruNotaryPubficUndeo.. '"'..: "