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<br />. <br /> <br />SECTION 19 <br />CONFUCT OF INTEREST STATEMENT <br /> <br />STATE OF FLO~A J <br />COUNTY OF /2rO c.LUY fA _ <br /> <br />BEFORE ME, the undersigned authority, personally appeared ta.I;Y\R, Rm ~ <br />was duly sworn, deposes, and states: <br /> <br />19.1: I a~e m~i~ me,rnbar <br />F5r,fe 1OvrJ1 V'itl} a local 0 Ice in ' <br />principal office in frjr: - J I'lh J~ } 'F-L <br /> <br />19.2. . The above named entity Is submitting a Bid for the City of Sunny Isles Beach, Bid No. <br />DB - 06 -02- described as: Janitorial Maintenance Services. <br /> <br />. who <br /> <br />of <br />and <br /> <br />19.3. The Affiant has made diligent inquiry and provides the information contained in this Affidavit <br />based upon his own knowledge. <br /> <br />19.4. The Affiant states that only one submittal for the above bid is being submitted and that the <br />above named entity has no financial interest in other entitles submitting bids for the same project. <br /> <br />19.5. Neither the Affiant nor the above named entity has directly or indirectly entered into any <br />agreement, participated in any collusion,. or otherwise taken any action in restraints of free competitive <br />pricing in connection with the entity's submittal for the above bid. This statement restricts the discussion <br />of pricing data until the completion of negotiations if necessary and execution of the Contract for this <br />project. <br /> <br />19.6. Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or <br />otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. <br /> <br />19.7. Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict <br />of interest due to any other clients, contracts, or property interests for this project. <br /> <br />19.8. I certify that no member of the entity's ownership or management is presently applying for any <br />employee position or actively seeking an elected position with the City of Sunny Isles Beach. <br /> <br />19.9. I certify that no member of the entity's ownership or management, or staff has a vested interest <br />in any aspect of the City of Sunny Isles Beach. <br /> <br />19.10. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the <br />above named entity, will immediately notify ~he City of Sunny Isles Beach. <br /> <br />Dated this 24- day of Jv nt:- . 2OOT. 20~ <br /> <br />AFAANT Print or Type Na~~a$I~~'111111. <br />~ \: ...... '!Jet ~ ~ <br />.... I'/ *' ~ ... q .l.. ""6-p..~ <br />Sworn to and subscribed before me1:his ...!::::.::J. day of ~ b. ~ ~ ... v;: ~ <br />D Personally Known ~- OR ~~: '" ~Z~v6V GGlI ... ~ ~ <br />D Produced Identification ; Type of tiflcatiQR.. : Jf.: <br />- ~ <br />... ~~ <br />~ z <br />NOTARY PUBUC STATE OF .... .~~~ ~ I <br />~IIII :.?zVW ~\\,,, <br />111'''"I1I1\\\\\~ <br /> <br />.2? <br />200\ <br /> <br /> <br />PAGE 75 OF 78 <br />