HomeMy WebLinkAboutConflict of interestCONFLICT OF INTEREST
City of Sunny Isles Beach
•., 18070 Collins Avenue
sr ➢' • v L o p�° Sunny Isles Beach, FL 33160
��`' o. su" '`• Telephone: (305) 947-0606 Fax: (305) 949-3113
CONFLICT OF INTEREST STATEMENT
The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must
disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the
City of Sunny Isles Beach or its agencies.
STATE OF FLORIDA
COUNTYOF Miami -Dade
BEFORE ME, the undersigned authority, personally appeared Richard Gomez who was duly sworn,
deposes, and states:
18.1. 1 aln the Vice President of
TGSV Enterprises, Inc. with a local office 71n-1301 Westree and principal office in
Same Location . Suite A, Hialeah FL 33014
18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 19 - 01- 01 described
as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this
Affidavit based upon his own knowledge.
18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has
no financial interest in other entities submitting Bids for the same project.
18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in
any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for
the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and
execution of the Contract for this project.
18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from
participation in contract letting by any local, State, or Federal Agency.
18.6 Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any
other clients, contracts, or property interests for this project.
18.71 certify that no member of the entity's ownership or management is presently applying for any employee position or
actively seeking an elected position with the City of Sunny Isles Beach.
18.81 certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City
of Sunny Isles Beach.
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
immediately notify the City of Sunny Isles Beach.
day of 200
i
A NT Print or Type T4ame and Title
Sworn to and subscribed before me this day of 2010.
® Personally Known OR
O Produced Identification ; Type of lden> fication
NOTARY PUBLIC STATE
ISA13EL CAMEJO-SMITH
MY COMMISSION # GG 186668
EXPIRES: June 14, 2022
Bonded Thru Notary Public Underwriters
DECEMBER 28, 2010 5 of 8