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<br /> <br />CONFLICT OF INTEREST <br /> <br />City of Sunny Isles Beach <br />1 B070 Collins Awn ua <br />Sunny Isles Beach. FL 33160 <br />Telephone: (305) 947-0606 Fax: (305) 949-3113 <br /> <br />CONFLICT OF INTEREST STATEMENT <br /> <br />The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must <br />disclose with their Bids, the name of any officer, director, partner, assodate or agent who is also an officer or employee of the <br />crty of Sunny Isles Beach or Its agendes. <br /> <br />STATE OF FL~&DA l <br />COUNTY OF XU r;(r;!} <br /> <br />BEFORE ME, the undersigned authority, personally appeared \-<.ct.rf,J ~\roJfL <br />deposes, and states: <br /> <br />18.1. I am the -:p res:t. ~-\ of <br />Act\~ lA I:AP 'I ~m(:r.."\"; rCf1\~ a local office In -"ft.k t-avIdof'n:{p. '\-r I fL and principal office In <br />(..0(5..... \pI'" ~~.FL .' <br /> <br />18.2. The above named entity Is submitting a' Bid for the City of Sunny Isles Beach, Bid No.lI- 05. 03 described <br />as: Landscape Maintenance Services. !he AffIant has made diligent Inquiry and provides the Information contained in this <br />Affidavit based upon hIs own knowledge. <br /> <br />, who was duly sworn, <br /> <br />18.3 The Affiant states that only one submittal for the above Bid Is being submitted and that the above named entity has <br />no financial Interest In other entitles submitting Bid~ for the same project <br /> <br />18.4 Neither the AffIant nor the above named entity has directly or indirectly entered into any agreement, participated in <br />any.collusion, or otherwlse taken any action In restraints. of free competitive pricing In connection with the entity's submlttar for <br />the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and <br />execution of the Contract for this project: <br /> <br />18.5 Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise Ineligible from <br />participation In contract letting by any local, state, or Federal Agency. <br /> <br />1Q.G Neither the ~ntity, nor its affiliates, nor anyone associated with them have any potential conflict of Interest due to any <br />o~er clients, contracts; or property interests for this project <br /> <br />18.71 certify that no member of the entity's ownership or management Is presently applying for any employee position or <br />actively seel<lng an elected position with the City of Sunny Isles Beach. <br /> <br />18.8 I certify that no member of the entity's ownership or management, or staff has a vested Interest In any aspect of the City <br />of Sunny Isles Beach. . <br /> <br />18.9 In the event that a conflict of Interest Is Identified In the provision of services, I, on behalf of the above named entity, will <br />Immediately l1ot1fy the City o~ny Isles Be~ <br /> <br />. ad this ~ V day of /9- , 20f'l. <br />€ S; I ct./f....) <br />FIANT ~ or Type Name and Title <br /> <br />Sworn to and subscribed before me this ;;. r; day of ~ 7 ' 2011. <br />~ Personally Known OR <br />o Produced Identification : Type 0 dentificatlon <br /> <br /> <br />NOTARYPUBLlC STATE OF FLORIDA <br /> <br /> <br />oT~!1e ATE 011 FLOlUDA <br />N ,,"'!:,. Marit7,a Gomez <br />t~i'~ Commission # DD8S4556 <br />~. '!ilff.i ExPires: APR. 27, 2013 <br />.'......",. ._ n'TICllofflllNGCo..IllC. <br />IlOHDJm nIRl1 "" "MU. <br /> <br />5of7 <br /> <br />OecEMBER 2B. 2010 <br />