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1 . . <br /> s„NYrs,,.., CONFLICT OF INTEREST <br /> to`' <br /> ,.,..--:.,.--;,.:,\9, <br /> _o---. :i+ City of Sunny Isles Beach <br /> f u =� - Z 18070 Collins Avenue - <br /> Sunny Isles each;FL 33160 - - <br /> I ?�'. --/�� Telephone:(305)947-0606 Fax:(305)949-3113 <br /> FLoco5 <br /> C'- of <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 /> - I must disclose with their aids,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 /> I STATE OF FLORIDA - <br /> COUNTY.OF <br /> BEFORE ME,the undersi fed authori Steven Glenn <br /> g ty,personally appeared <br /> Iwho was duly sworn,deposes,and states: <br /> 1. I am the Vice President of Tidal Basin Government Consulting, LLC <br /> office in with a.local <br /> in Utica, NY and principal office <br /> 2.The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid.No. 18-04-03 <br /> I <br /> described as Disaster Debris Monitoring Services&Financial Recovery Assistance . 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 <br /> I. named entity has no financial interest in other entities submitting Bids for the same project. <br /> 4. Neither the Affiant nor the above named entityhas 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 /> I 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 /> Iotherwise ineligible from participation in contract letting by any local,State,or Federal Agency. <br /> G. Neither the eni:ity,nor its affiliates,nor anyone associated with them have any potential conflict <br /> of 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 <br /> employee 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 /> I named entity,will immediately notify the City of Sunny Isles Beach. <br /> Dated this 8 day ofQ U ,20)O . <br /> In,�J._. / Steven Glenn,Vice President <br /> AFFIANT Q Print or Type Name and Title . <br /> I Sworn to and subscribed before me this U day ofirla 2O1 <br /> j Personally Known,OR <br /> r. <br /> 0 Produced Identification-Type of Identification <br /> NOTARY PUBLIC STATE OF FLAfi}$A 01t-� , , / . 7719ii / <br /> BRIANNA L.MOY€R 1' <br /> • Notary Public in the State of New York 5 of 10 ' <br /> I Qualified in Oneida County01M062fl4465 <br /> My Commission Expires Dec.P3 20 2.1 • <br />