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RFP No. 08-07-01 Emergency Debris Clearing and Removal
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AshBritt #1
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Last modified
3/23/2011 2:54:00 PM
Creation date
3/23/2011 2:45:11 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Emergency Debris Clearing
Bid No. (xx-xx-xx)
08-07-01
Project Type (Bid, RFP, RFQ)
RFP
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<br />G <br /> <br />SEcnON 19 <br />CONFLICT OF INTEREST STATEMENT <br /> <br />STATE OF FLORIDA <br />COUNTY OF Broward <br /> <br />BEFORE ME, the undersigned authority, personally appeared Randal R. Perkins <br />sworn, deposes, and states: <br /> <br />, who was duly <br /> <br />19.1. I am the <br />with a local office in <br /> <br />Chief Executive Officer <br />Pompano Beach. FL <br /> <br />and principal office in <br /> <br />of AshBritt. Inc. <br />Pompano Beach, FL <br /> <br />19.2. The above named entity is submitting a Proposal for the City of Sunny Isles Beach, RFP No. <br />D 8 - D 7 - D 1 described as: Emergency Debris Clearing and Removal Operations. <br /> <br />19.3. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his <br />own knowledge. <br /> <br />19.4. The Affiant states that only one submittal for the above Proposal is being submitted and that the above <br />named entity has no financial interest in other entities submitting proposals for the same project. <br /> <br />G <br /> <br />19.5. Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, <br />participated in any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with <br />the entity's submittal for the above proposal. This statement restricts the discussion of pricing data until the <br />completion of negotiations if necessary and execution of the Contract for this project. <br /> <br />19.6. Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise <br />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 of interest <br />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 employee <br />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 in any <br />aspect of the City of Sunny Isles Beach. <br /> <br /> <br />,2008. <br /> <br />o <br /> <br />AFFIANT <br />Sworn to and subscribed before me this _ day of <br />IJ Personally Known x OR <br />o Produced Ident!tl_HIII"'IIIII~ : Type of Id <br />~,\ ~ ~\[NE"11 . f//,-. , <br />~ ..::1: ..... ~ <br />Sf,"'..CVD.. ... <br />~ v ..,.Q.r.J~v.rtREs.. }f ~ <br />~~"~"?'<t.,2010.. ~, <br />:: <: .i!""".... "".. .d: 0;: <br />_.........::;> "'" ~.o- <br />- "' e>--..J ~ ~ -- <br />:: a: : ~-, ~o n'Ob. CI: !5 := <br />::::. !a'!)" ~. a:: ::: <br />... . ~~ ~.;f.., -. <br />~ . tlt.'VV ~l.;:or...':: <br />~ ),( ..~'Il ,~.. ",r::s ~ <br />~T ":'<.\>ultlro\l~.. ~v ~ <br />~ M ........ ~~ ~ <br />~,... V14FiYPUB\.\C" ~""" <br />;"u' u'\ <br />AshBritt, Inc. I Sunny Isles Beach, FL I K~IJIRI~Y-01 <br /> <br />Randal R. Perkins,CEO <br />Print or Type Name and Title <br />,2008. <br /> <br /> <br />76 <br />
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