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<br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <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 Antonio G. Acosta, P.E. <br />deposes, and states: <br /> <br />, who was duly sworn, <br /> <br />18.1. I am the President <br />A&P Consulting Transportation Enigneers_with a local office in _Doral <br />_Doral <br /> <br />of <br />and principal office in <br /> <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No, RFQ 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 />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 />18.9 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 /> <br />Immed,at:;;E,t(J"g tie, Bea,h. <br /> <br /> <br />~T ~ Print or Type Name and Title <br /> <br />Sworn to and subscribed before me this I ~t day of DJl c em h.e{Z. <br />o Personally Known OR ~ <br />if Produced Identification ; Type of Iden~tifi ation r L- <br /> <br />~ fJ <br /> <br />NOTARY PUBLIC STATE OF FLORIDA <br /> <br />,2010. <br /> <br />, 201~, <br />'])(li II ea s L i (~NCJ..t <br /> <br />,~ <br /> <br />.l~~~''!.t:",,, Julia E.8oyce <br />i~':l'~~ COMMISSIO,N 6EE088121 <br />-':!I.' .",,- <br />~~~.... ~iEXPIRES: FEB. 09,2014 <br />...."',~~\\'~ WWW.AARONNOJARY.c:cm <br /> <br />DECEMBER 28.2010 <br /> <br />5 of 7 <br />