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<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 FLORIQA <br />COUNTY OF 1-1 {Afv{ (0J.q)e <br /> <br />BEFORE ME, the undersigned authority, personally appeared Adriana Savino-Miller <br />deposes, and states: <br /> <br />, who was duly sworn, <br /> <br />President <br />with a local office in 12345 NE 6th Avenue - Suite A <br /> <br />of <br />and principal office in <br /> <br />18.1. I am the <br />Savino & Miller Design Studio, P.A. <br />North Miami, FL. <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 />18.9 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 />immediately notify the City of Sunny Isles Beach. <br /> <br />DaJ,e~t~iL _9J.8. _ ~ day of April ,2012 <br />~~ .6<C>tU.AA11t- ~J.U}-M.t.U-,-"..J <br />AFFIANT Print or Type Name and Title <br /> <br />Sworn to and subscribed before me this ...!.E....- day of Ap l?.; \ , 2012 <br />Cl Personally Known OR <br />(3""' Produced Identification v; Type of .I,tifi~ation <br /> <br />NOTARY PUBLIC STATE OF FLORIDA <br /> <br /> <br />- OD7-S:.?o-r;yro-o <br /> <br />\\,"11"'1 <br />"b\~"Y PlJ~'" CRISTlANA GRULLON <br />t"': .."'\ Notary Public. State of Florida <br />-. . It .. <br />\.s;.' · (:)'<J My Comm. Expires Aug 26. 2015 <br />8, "o"cc;~~'" Commission # EE 100586 <br />"11111" <br /> <br /> <br />50f7 <br />