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o o o SECTION 19 CONFLICT OF INTEREST STATEMENT STATE OF FLORIDA COUNTY OF BEFORE ME, the undersigned authority, personally appeared MAr ~ sworn, deposes, and states: 19.1. I am the fA ie /'O(Pr A-h/Jj offlc er with a local office in and principal office in lS-l-ftf!;rd , who was duly Of~~ ErDr&(>~ !:iru;ces, Ll.f.. Ilttll1,'/p; A-L eo . 19.2. The above named entity is submitting a Proposal for the City of Sunny Isles Beach, RFP No. ~ - OJ r 0 I described as: Emergency Debris Clearing and Removal Operations. 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 Proposal is being submitted and that the above named entity has no financial interest in other entities submitting proposals 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 proposal. 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 presenUy 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. F3~ Dated this 0..-- day of ~ ~3~ ,,-+- , 2008. ~ ~ - /Y\t1f 1< ~t-AF~ Ch;~rQ;erA-h'Ons . ~~FIANT ~~ Print or Type Name and Title othce.f Sworn to and subscribed before me this ~day of ~j'2r J '..-+- ,2008. uvPersonally Known OR o Produced Identification ; Type of Identification CCk:Z~ ~V1+ NOTARY PUBLIC STATE OF FLORIDA ERIKA HuNt NOTARY PUBUC: AlA~:STATE AT LARGE MY COMMISSION EXPIRES 03-29-201 0 76 ,.J (........... "I "