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<br /> FSJN 154 FJ CONFLICT OF INTEREST
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<br /> f=..,n City of Sunny Isles Beach
<br /> 411 G • ,.-..-, I 18070 Collins Avenue
<br /> •\.-...",.:,,,i...,. :` �: '
<br /> � � Sunny Isles each,FL 33160
<br /> } ,D �, Telephone:(305)947-0606 Fax:(305)949-3113
<br /> yF 9?-FLo 50
<br /> c'rY of iug '�a 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.D/B/A Bettoli Vending,.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 D4,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/City of Sunny Isles Beach.
<br /> LI t:Dated this day of /Ire'' I , 20 177
<br /> .....A.,_p..403e/ - fr c u t ;=fro air;I,: Oiv.egci•- 4,2416;313.
<br /> AFFIANT Print or Type Name and Title'
<br /> Sworn to and subscribed before me this 04.1 day of J ,�jN�till!'!1Ntt 20 1
<br /> 0 Pers ally Known,OR �L� ����\.Egl'c,L%,. .44I/,i
<br /> 41, Produced Identification-Type of Identification F--- --- 'D �— • • -,2:�V,�,
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