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l <br /> 1I O�`S00t4Yist,e CONFLICT OF INTEREST <br /> 0 `~.h <br /> '-i`b 0 City of Sunny Isles Beach <br /> ® u —'01, = _ <br /> 18070 Collins Avenue <br /> `- • Sunny Isles each,FL 33160 <br /> O S•.➢9p•s ;.00.%°.:N r•S Telephone:(305)947-0606 Fax:(305)949-3113 <br /> F F � <br /> c T r of Su~ Sao CONFLICT OF INTEREST STATEMENT <br /> 0 <br /> 0 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 FLORID <br /> ,;I COUNTY OF CA-d Sr <br /> ® BEFORE ME,the undersigned authority,personally appeared 'V he-I. e Mcg r OJesS <br /> ® who was duty sworn,deposes,and states: <br /> ® Prestige Auto Transport <br /> 1. I am the President of Towing& Recovery, Inc. with a local <br /> ® office in 1491 NE 130 Street North Miami, FL 33161 and principal office <br /> ® in 1491 NE 130 Street North Miami, FL 33161 . <br /> ® 2. The above named entity is submitting a Bid for the City of Sunny Isles Beach,Bid No. RFP 17-11-01 <br /> described as Towing Service . The Affiant has made diligent <br /> inquiry and provides the information contained in this Affidavit based upon his own knowledge. <br /> e3. 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 /> 0 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 /> til 6. Neither the entity,nor its affiliates,nor anyone associated with them have any y potential conflict of <br /> 0 interest due to any other clients,contracts,or property interests for this project. <br /> O 7. I certify that no member of the entity's ownership or management is presently applying for any employee <br /> 0 position or actively seeking an elected position with the City of Sunny Isles Beach. <br /> e8. I certify that no member of the entity's ownership or management,or staff has a vested interest in any <br /> 0 aspect of the City of Sunny Isles Beach. <br /> 0 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 /> ® Dated this 76 day of V¢L 2411 I A/ ,20 14". <br /> ® 0k to lc/aA a& ,. AI cAeile Moral�.s Pr-di/leaf <br /> AFFIANT Print or Type Name and Title <br /> O Sworn to and subscribed before me this j0 day of I�ol_Q n'1 i.Q r ,20 I- 7 <br /> 0 Personally Known,OR <br /> 0 [/Produced Identification-Type of Identification FL- DL. MGLI 0 ---(;P- S 1q 1 A03— <br /> 03--(3 <br /> 0 <br /> NOTARY PUBLIC STATE OF FLORIDA Samantha Jenkins <br /> f�♦ e-s\l e Auto I.f�i- W0BLIC <br /> °�f'. : STOTARY ATE OF FLORIDA <br /> 5of7 it <br /> 0- „_ ?Comm#66145197 <br />"PreCc) C. N ' i'c) Expires 9/21/2021 RFP-ii"1141 <br />