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o sotANY I sCFf 0 <br /> (1, G ' ' z <br /> CONFLICT OF INTEREST <br /> "',. ''", City of Sunny Isles Beach <br /> i.�,9'. "' ot r 18070 Collins Avenue <br /> f� F�01° v s‘ Sunny Isles Beach,FL 33160 <br /> ''or su.''~ 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 FLORIDA <br /> COUNTY OF <br /> BEFORE ME, the undersigned authority, personally appeared Sc4,f} rr 1 q(fr,r,A , who was duly sworn, <br /> deposes, and states: <br /> 18.1. I a�' the \7 ,j �j of` 1/$ <br /> Zvi_ with a local office in 1An\v-Aylnt,r and principal office in <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 1 2--Cg—©t 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 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 /> 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 /> 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 /> 18.7 I certify that no member of the entity's ownership or management is presently applying for any employee position or <br /> actively seeking an elected position with the City of Sunny Isles Beach. <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 /> 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 /> Dated this 3,0 day of 201 <br /> - Lt,* kr r co r�1 r VP 7 <br /> AFFIANT I Print or Type t'arts d Title <br /> Sworn to and subscribed before me this ?4-0 day of Se- <br /> yt nnliz/ ,2019, <br /> O Personally Known OR <br /> 'Ici Produced Identification ;Type of Identification VA- 4 i it -a6o z 9 d162, <br /> NOTARY PUBLIC STATE OF FLORIDA /� 14 ii2,----- <br /> o�►K'Nit, Notary Public State of Florida <br /> ? `t', Renee M Liber <br /> iA i' My Commission EE150287 <br /> '?0,no Expires 12/13/2015 <br /> DECEMBER 28,2010 5 of 10 <br />