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RFP No. 12-10-03 Artificial Turf for Senator Gwen Margolis and Pelican Community Parks
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Hellas Construction, Inc.
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Last modified
12/13/2012 12:09:59 PM
Creation date
12/13/2012 12:09:33 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Artificial Turf for Senator Gwen Margolis & Pelican C.Parks
Bid No. (xx-xx-xx)
12-10-03
Project Type (Bid, RFP, RFQ)
RFP
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`%otter <br /> `r ? -. I <br /> CONFLICT OF INTEREST <br /> \ City of Sunny Isles Beach 1 Coffins Avenue <br /> \'• .rvo"‘oa Sunny Isles Beach,FL 33160 <br /> °'sus.� 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 FLO � ,S <br /> COUNTY OF Y t <br /> BEFORE ME, the undersigned authority, personally appeared Iril 11 (who was duly sworn, <br /> deposes,and states: J..X � }�,.� ��(/per <br /> ' 9 4ti Hip �� , ,�if. " _ I th a local ffice in K.Vfir and principal office in <br /> '4i76a5F•II�!ilE . <br /> 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid Not. '1 0—Cn 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 /> ® <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 /> 18.71 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 /> � . this � It ' _ _'�J ,201 <br /> J7.. .. . . �1�,. 1. ..uu fa tea . <br /> T0' • NT ' ' y'� Print or T .e Name and I i e <br /> • <br /> Sworn to and subscribed before me tXff day of r },f" ,2019.% <br /> 4 Personally Known OR . 1 <br /> Produced Identification T pe of Identification IV- <br /> NOTARY PUBLIC STATE OF FLORIDA &"' W • �04 t-ei <br /> ® •'�fy SARA EIYSE G e <br /> Notary Public,State UTIERR of Z Texas <br /> f My Commission Expires <br /> '',N V December 29, 2014 <br /> DecexeER 28,2010 5 of 10 <br /> Hellas Construction,Inc. RFP#12-10-03 P.102 <br />
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