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111 <br /> yVMNT (F. CONFLICT OF INTEREST <br /> O •�:S'..fl <br /> Gty of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> 4"r'_ Sunny isles each.FL 33160 <br /> •���^L"r_,,t'i- Telephone:(305)947-0606 Fax:(305)949-3113 <br /> F Lo' +' <br /> CONFLICT OF INTEREST STATEMENT <br /> The award of any contract hereunder is subject to the provisions of Chapter 112,Florida State Statutes. Proposers <br /> must disclose with their Bids,the name of any officer,director,partner,associate or agent who is also an officer or <br /> employee of the City of Sunny Isles Beach or its agencies. <br /> STATE OF FLORIDA <br /> COUNTY OF Miami-Dade <br /> BEFORE ME,the undersigned authority,personally appeared Maurizio L Bettoli <br /> who was duly sworn,deposes,and states: <br /> 1. I am the Director of Operations of Bettoli Trading Corp.DB/A Bettoli Vendinjg,ith a local <br /> office in 6095 NW 167th street Ste D4,Miami, FL.33015 and principal office <br /> in 6095 NW 167th street Ste 04.Miami.FL,33015 <br /> 2. The above named entity is submitting a Bid for the City of Sunny Isles Beach,Bid No.RFP17-03-01 <br /> described as Citywide Healthy Vending Machine Services . The Affiant has made diligent <br /> inquiry and provides the information contained in this Affidavit based upon his own knowledge. <br /> 3. The Affiant states that only one submittal for the above Bid is being submitted and that the above named <br /> entity has no financial interest in other entities submitting Bids for the same project. <br /> 4. Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, <br /> participated in any collusion,or otherwise taken any action in restraints of free competitive pricing in connection <br /> with the entity's submittal for the above Bid. This statement restricts the discussion of pricing data until the <br /> completion of negotiations if necessary and execution of the Contract for this project. <br /> 5. Neither the entity nor its affiliates,nor anyone associated with them,is presently suspended or otherwise <br /> ineligible from participation in contract letting by any local,State,or Federal Agency. <br /> 6. Neither the entity,nor its affiliates,nor anyone associated with them have any potential conflict of <br /> interest due to any other clients,contracts,or property interests for this project. <br /> 7. I certify that no member of the entity's ownership or management is presently applying for any employee <br /> position or actively seeking an elected position with the City of Sunny Isles Beach. <br /> 8. I certify that no member of the entity's ownership or management,or staff has a vested interest in any <br /> aspect of the City of Sunny Isles Beach. <br /> 9. In the event that a conflict of interest is identified in the provision of services,I,on behalf of the above <br /> named entity,will immediately notify the CityCiof Sunny Isles Beach. <br /> Dated this �I - • <br /> day of /1)t/'' I 20)7—.m -) y� <br /> .�/��^yj'r' �Q u !>? O I Zk[f U l IJ re- C rev- c l�Ra rcJ jp rS <br /> AFFIANT Print or Type Name and Title <br /> Sworn to and subscribed before me this d L-( day of \``\i111tt111!lift/rJ,�J20 1 <br /> 0 Pe ally Known,OR <br /> Produced Identification-Type of ldentif cation 1"/] Z 14. <br /> NOTARY PUBLIC STATE OF FLORIDA <br /> EFt <br /> 7, <br />