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o o o ~ SECTION 20 DISPUTE DISCLOSURE FORM 20.1. Has you firm or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulations or any other regulatory agency or professional associations within the last five (5) years? YES NO x 20.2. Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years? YES NO x 20.3. Has your firm had against it or filed any requests for equitable adjustment, contract claims, Proposal protests, or 6tigation in the past five (5) years that is related to the services your firm provides in the regular course of business? YES x NO If yes, state the nature of the request for equitable adjustment, contract claim, litigation, or protest, and state a brief description of the ease, the outcome or status of the suit and the monetary amounts of extended contract time involved. Ceres has requested, been approved, and received changes to contracts with government entities in the past. All monetary amounts involved have been minor and no changes are expected for this contract. I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation of falsification of facts shan be cause for forfeiture of rights for further consideration of this Proposal for the City of Sunny Isles Beach, RFP No. 08-07-01, Emergency Debris Clearing and Removal Operations. Ceres Environmental Services, Inc. Firm glc;gT/~ Date Steven M. Johnson Corporate Secretary Print or Type Name and Tide END OF SECTION 77