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L&L Truck Repairs
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(12-07-01) Fleet Bus Maintenance and Repair Services
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L&L Truck Repairs
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Last modified
8/1/2012 4:41:38 PM
Creation date
8/1/2012 4:39:57 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Fleet Bus Maintenance & Repair Svcs.
Bid No. (xx-xx-xx)
12-07-01
Project Type (Bid, RFP, RFQ)
Bid
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SUr1NY.Ib��� <br />CONFLICT OF INTEREST <br />u - _ <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />F L0, Sunny Isles Beach, FL 33160 <br />c�}I" of sun � Telephone: (305) 947 -0606 Fax. (305) 949 -3113 <br />CONFLICT OF INTEREST STATEMENT <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 />STATE OF FLO,, IDA <br />COUNTY OF /. � <br />iu, BEFORE ME, the undersigned authority, personally appeared � • ,r & who was duly sworn, <br />deposes, and states: <br />18.1. 1- am the Tr esSi � of <br />� <br />.t- L Toc r—' with a local office in VWkO.—t,k and principal office in <br />VA Wk V%A <br />18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. J 0 -7 ° V 1 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 />18.3 The Afflant 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 />18.4 Neither the Afflant 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 />18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from <br />participation in contract letting by any local, State, or Federal Agency. <br />18.6 Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any <br />other clients, contracts, or property Interests for this project. <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 />18.81 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 />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 />D ted this day of � V <br />=' <br />FIANT Prifit or Type Name an 'Title <br />Sworn to and subscribed before me this day of 2010. <br />0 Personally Known OR <br />Produced Identification Type of Identification <br />NOTARY PUBLIC STATE OF FLORIDA <br />rO1P:0- Notary Public State of Florida <br />Osvaldo Duran <br />ExpeS07/27/2014012243 <br />QECEMBER 28, 2010 5 Of 7 <br />
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