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<br />. <br /> <br />(> <br /> <br />. <br /> <br />SECTION 19 <br />CONFLICT OF INTEREST STATEMENT <br /> <br />STATE OF FLORIDh A",t>.. I 1/7'1 <br />COUNTY OF ~CV~ <br /> <br />BEFORE ME, the undersigned authority, personally appeareL~ y- \~ h 1-10 L- \2...\'lJ) (, "Who <br />was duly sworn, depq~ and states: d . L. I ("l ~tyw:.h/''(''5' d ~L( <br />19.1. I am the V \ I - Y'r-f..S t ..VP-1 - of&r-e.l. -rGJ-lY"O 0 with <br />a local office in JV II tm.. ~ .' ft and principal office in K <br /> <br />19.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 08-10-01 <br />described as: SR A1NCollins Avenue Streetscape Improvements. <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 entities 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 has any potential conflict of <br />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 the City of Sunny Isles Beach. <br /> <br />D~ed this ,-C) day of :D(,{'e..~y'\\o-e)y <br /> <br />'y {J~ l ~ \ ~ \J \ tp - <br /> <br />, 2012K. <br />\V'rt-~ '\ ',~\ <br /> <br /> <br />Sworn to and subscribed before me this -S- day of ~ -r:::.-<..... <br />o Personally Known OR <br />o Produced Identification ; Type of Identifica . <br /> <br />JERRY MURAT <br />Notary Public, State ot Florida <br />CommlssiOn# 00723357 <br />My comm. expires Oct. 09. 2011, <br /> <br />PAGE 80 OF 130 <br />BID No. 08-10-01 <br />