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CONFLICT OF INTEREST
<br />Cit, or bunny Isles SeacR
<br />a
<br />18070 Calkins Avenue
<br />• Senny Flee each, FL 33160
<br />•�. -� telephone: 13051947 060fi Fax: '3051949-3113
<br />♦ DD — —
<br />cC•�� ■r ;=N ■�
<br />COMFEICT OF II91CREST —biAi EMENT
<br />I Rc or flm, eomiraeT Rercerlser i3 3eB;ccl to TRe prozi.,ior13 vT CRapter 111, Fla, iilo St.tc 5tatetc.. Popo'.e.,
<br />must disclose with their Bids, the name of any officer, director, partner, associate or aisent who is also an officer or
<br />employee of the City of Sunny Isles Beach or its agencies.
<br />S I A I E OF FEDRI13A/r{`�����
<br />COUNTY OF _
<br />BEFORE IME, tRe untlersigne0 autRoriry, personally appeared
<br />-na -as azil, 3 .,,fin, 0cro3e3, ora It jote.:
<br />�,�d T
<br />. I am the/of Zt✓z/i� L'q•� i,rx- � � _' _ with a local
<br />orrice in —', �_%l kF_ an0 principal orrice
<br />2-
<br />i Me
<br />1Re aoove name0 entity is suomiLdrig a Bia tor tRe City or bunny Isles SeacR, Bis Mo. ./
<br />t1c3-Ficca o ( ` i t< ; - Re Arnont Ras nlosc ailisent
<br />in-yuir9 and provides fhe information contained in this Affidavit based upon his own knowledge.
<br />J. I Re Arrant states that oni, one su0mittal tor the aCo a Bio is dei -,g saWEtea anB tRat tRe spas
<br />named entity has no financial interest in other entities submittins Bids for the same protect.
<br />z;. Meitner tRe Arnant nor tRe aoove names entity Ras Directly or inOirectly entered into any agreement,
<br />porrrieir.te0 in ony eolle.lon, or otRerwi3e taRc;-. omy action In r=Btrolnts or Trcc coTpctitiae pricins in eonneetivn
<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
<br />otherwise ineligible from participation in contract letting by any local, State, or Federal Rgent:7.
<br />6. Iveitner tfle entity, nor ;ts orriiiotes, nor anyone associates -itri tRe- Have any potential conflict
<br />of interest due to any other clients, contracts, or property interests for this protect.
<br />�. I certify tRat Ra R1crmuer or tRc cntit,'3 or mon.een7ent i3 prc,c-tl,-FPI,.Rg
<br />employee position or actively seekinr, an elected position with the City of Sunny Isles Beach.
<br />S. 1 cc: t.ry Mat no rnen,oer or the entity', a -mc.- Rip ar rnarvagcment, or Tu1T Raz intcre�t iR an,
<br />aspect of the City of Sunny Isles Beach.
<br />V. In tRe event tRat a connict or interest is illendfiea in ine provision or services, I, on Wall or tRe al3ove
<br />❑arnca mtit,, ..ill ern eaiotely natiry tRc City or Senn, 131e3 BeacR.
<br />A
<br />as!!s''� . :^•mo i_. !f _ 'e-5
<br />Print or Type Name and Title
<br />sworn to anti su0scrine0 Berore me AS gay or �/c�fJ257,
<br />Pcr3onolly Known, OR
<br />❑ Pro0uceti 10entillcation - 1)
<br />iaV 1ART POSEIIi 31 A] 11 OF FLORIDA
<br />Lukes' Lan53uaVing, Inc.
<br />SotlU
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