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<br />. <br /> <br />'"'.t~ <br />< . <br /> <br /> <br />CONFLICT OF INTEREST <br /> <br />City 01 Sunny Isles. Beach <br />18070 Colfll'tSAvenue <br />Sunny 1.las Beach, FL 33180 <br />TeIepI1one: (306) 947-<l808 Fax: (305) ....3113 <br /> <br />CONFLICT OF INTEREST STATEMENT <br /> <br />The award of any conlract hereunder Is subject to tha provisIons of Chapter 112, Florida Stela staMes. Proposers must <br />disclose with thelr Bids, the nama of any officer, director, partner, associate or egent who Is elso an officer or employee of the <br />Cny 01 Sunny Isles Bssch or Its agencIes. . <br /> <br />STATE OF FLORIDA \ <br />COUNTY OF . P,YoW"~ <br /> <br />BEFORE ME, the undersigned authority, person any appeared AI.... b......... ~...i; <br />deposes, snd Blales: ./ <br /> <br />18.1. I am ths ~-...:~ to:::i:. o..-k.. of <br />~..ll..<-~... l& u)\" eN 6. r"c .wfth a local office In /114-:1.. ~. .,.....,.. . and principal office In <br />P>>f" 4<4 'FI.):J:) e( <br /> <br />18.2. The above named entity Is submitting a Bid for the. City of Sunny Isles Be~h, Bid No. I().- Or -01 described <br />as: landscape MaIntensnce Servfcea. Tha Affiant hes made dlllgentlnqulry and provides the Inlonnatlon contelned In this <br />Affidavit based upon his own knowledge. '. . <br /> <br />, who was duly swam, <br /> <br />18.3 The Affiant ststes that only one submittal lor the above Bid Is being submitted and that the above named entity has <br />no flnanclal Interest in other entitles submfttfng BIds for the same project. . <br /> <br />18.4 Neither the Affiant nor the above named entity has directly or IndlrBclly sntared Into any agreement, per1iclpated In <br />any collualon, or otherwise teken any aellon In reBlralnts 01 free competitive pricIng In connsction with the enllly's submlltellor <br />the abova Bid. ThIs atetement restrict. the discuss/on of pricing data until the completion of negolfslions II necessary end <br />execution of Ihe Contract for Ihls projecl. <br /> <br />18.5 Nelther the entity nor Its affiliates, nor anyone assocleted with tham, Is presently suspended or otherwise Ineligible from <br />participation In conlract letting by any local, Slate, or Federal Agency. <br /> <br />18.6 Neither the entity, nor Its affiliates, nor any one assocIated with them heva any potential conflict of interest due to eny <br />other cllenla, contracts, or property Inlaraate for this project. <br /> <br />18.7 I certify that no mamber of the entity's ownershIp or menagementle presen1ly applying for any employae poslllon or <br />actively Seeking an elected position with tha City of Sunny Islas Besch. <br /> <br />18.8 I certify thai no member of the enffty's ownarshlp or manegement, or staff has a vested Interest In any upect of the CIty <br />of Sunny Isles Beach. <br /> <br />18.9 In the event that a conflict 01 Interast Is Identified in the provision of services, I, on behell 01 the above named entity, will <br />Immediately notlty tha City of Sunny Isles Beac . <br /> <br />Dated this day 01 '(JIIJ <br /> <br />It. AFFIANT <br /> <br />s..v.{" to and subscribed before me thlS~ day of <br />,gr" Personally Known OR <br />CI Produced Identfficallon ; Typa 01 Ida <br /> <br /> <br />NOTARY PUBLIC STATE OF FLORIDA <br /> <br />OiCBIBER 29. 2010 <br /> <br />50f7 <br /> <br />c., .,; ~'~1 <br />,~) i! L,.l <br />