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<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 _I _
<br />COUNTY OF 1)~
<br />
<br />BEFORE ME, the undersigned authority, personally appeared _T='. ~~\O ~Sc..bP. who was duly sworn,
<br />deposes, and states:
<br />
<br />the rpri () ~ of
<br />with a local office in at ~ u.~ LLcM \'3\1bf and principal office in
<br />
<br />18.1. I am
<br />\..\VS ~~S
<br />~
<br />
<br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No, 1'.2. - OY - Ot.{ 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 />18.7 I certify that no member of the entity's ownership or management is presently applying for any employee position or
<br />actively seeking an elecled 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 />'2-
<br />201~.. ;... "" 0
<br />1='. ~hrni(') ~ I Fr'(\~v
<br />AFFIANT Print or Type Name and Title
<br />
<br />Sworn to and subscribed before me this ~ day of A-.ar~L ,201i~
<br />~ Personally Known OR L..!.f"-
<br />o Produced Identification ; Type of Identification ~
<br />
<br />0~^1,-~
<br />NOTARY PUBLIC STATE OF FLORIDA
<br />
<br />.,' '.:,> .. YMARllN
<br />;} :'i," MY COMMISSION' DO ft..;:..,,,,
<br />-' ..... -' ~:' ~. \T.~ 11(\\
<br />. "\';:~~<l" EXPIRES: March 7, 2014
<br />. 'j'" B\lMed Thru Budget NolaI}' SefVl~i
<br />
<br />Dated this
<br />
<br />3Q
<br />
<br />~.\ l.,
<br />
<br />dav of
<br />
<br />DECEMBER 28,2010
<br />
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