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<br />CONFLICT OF INTEREST
<br />
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<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, associate or agent who is also an officer or employee of the
<br />City of Sunny Isles Beach or its agencies,
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF Palm Beach
<br />
<br />BEFORE ME, the undersigned authority, personally appeared Thomas F. Mullin
<br />deposes, and states:
<br />
<br />18.1. I am the V.P., Manager of Engineering/Geotechnical Design Seqni.ces of
<br />URS Corporation Southern ~1. a local office in Fort Lauderdale and principal office in
<br />San Francisco
<br />
<br />, who was duly sworn,
<br />
<br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No, 11-07-01 described
<br />as: Speci.o 1 Tn c:pP("t-; (''In ~""'s The Affiant has made diligent inquiry and provides the information contained in this
<br />Affidavit based upon hiS own knowledge.
<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 entities submitting Bids 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 otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal 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 />
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<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 />18.6 Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any
<br />other clients, contracts, or property interests for this project.
<br />
<br />18.7 I certify that no member of the entity's ownership or management is presently applying for any employee position or
<br />actively seeking 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 />18.91n 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 notify the City of Sunny Isles Beach.
<br />
<br />
<br />D'(J't;,,:-W;;;:1& t'.l!;.ljf 7}..~ !-:I'lI"I/:",
<br />
<br />AFFIANT I Print or Type Name and Title
<br />19.. j()
<br />S'lJdrn to and subscribed before me this L- day of ~ '-1
<br />Iii' Personally Known OR' /
<br />o Produced Identification 1111 P ; Type of Id/e;?;e::"~~ "'
<br />
<br />
<br />NOTARY PU ~
<br />
<br />~..t~~lt~:", ~HIRLEY STARK
<br />1m ~ Notary Public - State 01 Florida
<br />\. ~~ My Comm. Expires Mar 22. 2015
<br />"'~'~f~~.$ Commission II EE 49014
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<br />5 of 7
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<br />DECEMBER 28. 2010
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