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<br />) <br /> <br />~ <br />J <br /> <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br /> <br /> <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 Miami-Dade <br /> <br />BEFORE ME, the undersigned authority, personally appeared Carlos H. Perez, PE <br />deposes, and states: <br /> <br />, who was duly sworn, <br /> <br />the President <br />with a local office in Doral FL <br /> <br />18.1. I am <br />CH Perez & Associates <br />Dora!. FL <br /> <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 11-11-02 described <br />as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this <br />Affidavit based upon his own knowledge. <br /> <br />of <br />and principal office in <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 /> <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 />18.71 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 e ent that ~o flict of interest is identified in the provision of services, I, on behalf of the above named entity, will <br />immediately tify the City f Sunny Isles Beach. <br /> <br />Oat d t 's s of December, 2011 ,201M. <br />tv' Carlos H. Perez, PE. President <br />NT Print or Type Name and Title <br /> <br />S to and subscribed before me this -.t'd.L day of L. ~e 1'1'7 L , 201jld. <br />~ /' Personally Known OR / <br />[V""" Produced Identification ; Type of Identification, 7) ~ y(K h 'c,rl,5 e <br />-- <br /> <br /> <br />NOTARY PUBLIC STATE OF FLORIDA <br /> <br />DECEMBER 28, 2010 <br /> <br />f'?~(2l <br />\""". --- <br />it~V.~~~'" Mana leonor Mendes ev.- <br />t,-?::"4b"!~ COMMISSiON 11 DD957786 <br />~~..:.:~.~~~ EXP!RES: FES.02 2014 <br />":~' '... c....... I <br />"'"P,~,~,"~ \~I'{W.I'\I\RONNOTARY.~\9f 7 <br />