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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 Dade <br /> <br />BEFORE ME, the undersigned authority, personally appeared Aida M. Curt i s <br />deposes, and states: <br /> <br />, who was duly sworn, <br /> <br />18.1. I am <br />Curtis + Rogers <br /> <br />~e President <br />with a local office in <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, 12 - 04 - 04 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 />18.91n 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 />Dri thJs ? 0 t; of A f rl l <br />l r1 CL.J , . -:to <br />AFFIANT \ Print or Type Name and Title <br /> <br />Sworn to and subscribed before me this 312- day of ()--pvz. L <br />~ Personally Known OR ' / <br />o Produced Identification ; Type of Identification ;0 iJ- <br /> <br />v1;-u~ 'F~ <br /> <br />, 201a. <br /> <br />, 2010L <br /> <br />NOTARY PUBLIC STATE OF FLORIDA <br /> <br />r <br /> <br /> <br />, Notary Public State of Florida <br />Zenaida' Fernandez <br />My Commisslon,iE 157804 <br />Expire.01/17l2d'1a <br /> <br /> <br />(t; <br /> <br />DECEMBER 28, 2010 <br /> <br />5 of 7 <br />