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HomeMy WebLinkAboutAtlanov, LLC i..o'' ATLan®v ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 1- -j J - Q -, a 11.- I (e \ BID NO. 16-03-01 MOTOR COACH TRANSPORTATION SERVICES CITY OF SUNNY ISLES BEACH ATLANOV, LLC 1990 NE 163RD STREET, #227, NORTH MIAMI BEACH, FL 33162 (786) 520-3279 DUE DATE AND TIME: WEDNESDAY, MARCH 30, 2016 AT 2:30 P.M ORIGINAL AlLanov ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Transmittal Letter RECE VED March 30, 2016 HAR3302016 z:3t �"� City W Surry 131-as B&a:h CM:eoI eCity C=rk Ms.Jane Hines City Clerk The City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, Florida 33160 Re: Invitation to Bid (ITB) No. 16-03-01 Dear Ms. Hines, On behalf of Atlanov LLC., We greatly appreciate your invitation that allows us to propose our bid for the City of Sunny Isles Beach, Florida. Along with this letter, please find our enclosed bid submittal for the opportunity to provide motor coach transportation services. After reviewing the referenced bid, Atlanov LLC., fully understands the significant requirements for the City of Sunny Isles Beach, Florida. Here at Atlanov LLC.,We are highly confident to provide and service The City of Sunny Isles Beach in accordance with all of the terms in your Invitation to Bid (ITB). Should you require any additional information or have any other inquiries regarding our proposal, we trust that you will contact us by phone or e-mail. We are grateful for your interest in our company and we hope to have the pleasure of working with you and The City of Sunny Isles Beach. We look forward to your confirmed acceptance of our proposal. Names of the persons who will be authorized to make representations: Denis Atlanov Address: 1990 NE 163rd Street Suite tt227 North Miami Beach, Florida 33162 Telephone: (786) 520-3279 Email: da@atlanov.com Sincerely, Denis Atlanov CEO and President Atlanov LLC. 2 ATLanov ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Table of Contents 1. Bid Form 1 (Bid Cover) 4 2. Bid Form 2 (Addenda Acknowledgement) 6 3. Bid Form 3 (Vendor Required Information & Documents) 7 4. Non-Collusion Affidavit 9 5. Public Entity Crimes 10 6. Equal Opportunity/Affirmative Action 12 7. Conflict of Interest 13 8. Dispute Disclosure 14 9. Anti-Kickback 15 3 ATLanov ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Bid Form 1 (Bid Cover) BID FORM 1 BID COVER Bid Title: MOTOR COACH TRANSPORTATION SERVICES The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an agreement with The City of Sunny Isles Beach to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid and in accordance with the other terms and conditions of the Contract Documents. The Bidder accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to Bidders. This Bid will remain subject to acceptance for 90 days after the day of Bid opening. The Bidder agrees to sign and submit the Agreement with other documents required by the Bidding Requirements within ten days after the date of the City's Notice of Award. In submitting this Bid,the Bidder represents,as more fully set forth in the Agreement,that • The Bidder has familiarized himself/herself with the nature and extent of the Contract Documents, Work, site, locality, and all local conditions and Law and Regulations that in any manner may affect cost, progress, performance, or furnishing of the Work. • The Bidder has given the City written notice of all conflicts,errors, discrepancies that it has discovered in the Contract Documents and the written resolution thereof by(Sty is acceptable to the Bidder. • This Bid is genuine and not made in the interest of or on behaff of any ung person,fon or corporation and is not submitted in conformity with any agreement or rules of any group,association,organization,or corporation;the Bidder has not directly or indirectly induced or soficited any other Bidder to submit a false or sham Bid; the Bidder has not soficited or induced any person, firm or corporation to refrain from Bidding; and Bidder has not sought by collusion to obtain for itself any advantage over any other Bidders or over the City. Exact I e.yI Company Name: AtlanOv, LLC Business Name(dba), if any: Street Address: 1990 NE 163rd Street,Suite 227, North Miami Beach, FL 33162 Mailing Address(if different): 4 Alianov ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES:BID NO. 16-03-01 Bid Form 1 (Bid Cover) Tdephpre No.: (786)520-3279 Fax : (786)520-3279 Fins AddresK da©atlanov.com FEW Na: 61-1771007 By signing this document the bidder egrets W all Terms Autla Lted Signature: a print Name: Denis AUanov ran CEO and President THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF BIDDER TO BE BOUND BY THE TERMS OF ITS PROPOSAL FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE PROPOSAL NON-RESPONSIVE. THE CITY MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY PROPOSAL THAT INCLUDES AN EXECUTED DOCUMENT WHICH UNEQUIVOCALLY BINDS THE BIDDER TO THE TERMS OF ITS OFFER 5 Allanov a ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Bid Form 2 (Addenda Acknowledgement) BID FORM 2 ADDENDA ACKNOWLEDGEMENT INSTRUCTIONS:COMPLETE PART I OR PART D,WHICHEVER APPLIES PART I: LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION WITH THIS BID Addendum #1, Dated Addendum #4 Dated Addendum #3, Dated Addendum #4, Dated Addendum #5, Dated Addendum #6, Dated Addendum #7, Dated Addendum #8, Dated PART II: V NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID COMPANY NAME: Atianov, LLC AUTHORIZED SIGNATURE: �/ DATE: 03!302016 TITLE OF OFFICER: CEO and President 6 ATLan®v ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Bid Form 3 (Vendor Required Information & Documents) BID FORM 3 VENDOR REQUIRED INFORMATION&DOCUMENTS Sedion Summarized Requirement Initial to indicate completed Contact Information (wadable 24/7) 25a Telephone (786) 520-3279 Df} Email da@atlanov_com Fax (786) 520-3279 25b Vehicle Communication System Q� (Attach to this page,Ed Form 3) 2.5c Vendor Fleet Listing 1)A (pita to this page,Bid Form 3) 25d Vendor Hourty Rate (47-57 Passenger motor coach) .0 ,4 $ 80.00 2.5b Listing of the vehicle communication system in place (e.g., mobile phones or two-way radio equipment), that allows regular communication with all vehicles providing transportation services. All drivers will have a personal cell phone that will allow them to be reachable at all times. Drivers will not use cell phones (talking or texting) while operating vehicles. 2.5c Listing of the Vendor's fleet (include Vehicle #, Make, Model, Year, Capacity, Own/Lease). We have 3 beautiful full size luxury coaches (56 Passenger Luxury Coach) Vehicle # 551 / 1999 VanHool / 55-Seats/ License Plate # 366HCV/ OWNED Vehicle # 572 / 2001 VanHool / 57-Seats/ License Plate # M194NV/ OWNED Vehicle # 581 / 2007 MCI / 60-Seats/ License Plate # AMPF77/ OWNED 7 . • Allanov ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Bid Form 3 (Vendor Required Information & Documents) And 4 clean (Multiple Mini Buses, Seating for 39 Passengers, 5 flat screen TV's. Full size restroom) comfortable mini buses to service your transportation needs. Vehicle # 292/ 2005 Freightliner/ 29-Seats/ License Plate # HCG31/OWNED Vehicle # 332 / 2005 Eldorado / 34-Seats/ License Plate # 9801TP / OWNED Vehicle # 335 / 2001 Eldorado / 33-Seats/ License Plate # 751TNL/ OWNED Vehicle # 336/ 2003 Eldorado/ 32-Seats/ License Plate # 3398YKE / OWNED 8 • • 1 TLanov ATLANOVa LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Non-Collusion Affidavit ,„t!t•• o. ”' NON-COLLUSION AFFIDAVIT I' City of Sunny Isles Beach lean Conn:Avenue •.�oe'e 2w-3 Ise:Beam.M. 33 lea or ,. Teton'=e:(33S)nF7C635 Fir(3c_19=9-3113 STATE OF FLORIDA, ) COUNTY OF f1 Y1 I'-n,� o, I ' me undersigned Deng first duly sworn as crowned oy raw,deposes,and says: TNs Affidavit Is made with me knowledge and Intent mat it Is to de filed with me Cay of Sunny Ines Beacn City Cammisldn and Mal It win be relied upon try said County,In any conslderdton widen may give to and any acton it may tate wilt respect to pus BIa. Tile underskgned Is a ntiOnZed to make this A.'taalti on Dena?of. Atlanov,LLC (Name at Corporrlm.Pannersnto,Indlttdual,etc.) a. Limited Liabdity Company ,romea under me laws of Florida (Type a Bushess) (State) awhichhe 15 CEO and President (Sae(Twner.Palter,?reticent.etc.) Wenner the undersigned nor any person, firm, or taporaton named In above Paragraph 10.2• nor anyone else to the tr)vwtedge or the unosrsigned.nave themselves scanned or employed anyone else to soot favorable action tar Vas Bid Dy the Coy.also mm ro nem Of any depattient a employee meretn or any(Meer of the City of Sunny Isles Beam Marna Is mecty=restart therein. Tins 610 Is gen=e ana not cache a a snam;me person.omit or corporation named above in Paragraph 102 Ras not Comma,euispund. connived or agreed directly a Manny with any proposers a person,Nm or caporadon,to put In a snam End.Or that SUM person.Can or caporator.,seal retell tram Bidding,and has not In any manner,dtrecry a tidieCcy.sought by agreement or(=minor,or danmmlcaton or conference with any person,firm or corpordton,to Ds the prices of sat Bid a Bids of any other proposers;and as statements coniteC In me 61a or Bids desalted above true: aria NrtRer, neper me undersigned,nor me person.nun or corporin=named above In Paragraph 102.has=may a Indirectly stmmited said co a me Contend thereof.or divulged Inronnatlon a data retaUve thereto,to any assocH1on or to any member or agent thereof. / Denis Atlanov .� CEO and President AFFIANTS NAME 4, AFFIANTS TITLE /� // TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 69 day a it kiEc .aJOje Personally Known or Produced wen:m=aam Tyx ataefrcaca.tm pot. A 34 S-141 71'(a�b ikit (ACh seal here) Uty&;-, k vV 9.... NOTARY PUBLIC(name pnmea Or typed) ( VALERIE WOLIVER 0 '1 ` Notary Public-State of Florida' ) ( ' �_ Commission f FF,933386 ( ', �'- = My Comm.Expires Jan 21,2020 ' I "`°-t1g Sonded0uos98 National Notary Ann. l . 9 ' TLanov 9 ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Public Entity Crimes PUBLIC ENTITY CRIMES City of Sunny Isles Beach AV; 13070 Calms Ave IE �ic�� swPyI Wes Beast FL 331W ,,a"•a..� TeleOmmne:(305)937-0606 Fa(305)W9-3113 SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a) FLORIDA STATUTES,ON PUBLIC ENTITY CRIMES PUBLIC ENTITY CRIMES Pursuant to the provisions of paragraph(2)(a)of Section 287133, Florida State Statutes-'A person or affiliate who has been placed on the convicted vendor list fol bwirg a conviction for a public entity crime may not submit a Bid on a Contract to provide any goods or services to a public entity, may rot submit a Bid on a Contract with a public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of real property to a public entity,may not be awarded to perform Work as a Contractor, supplier,Sub-Contractor,or Consultant under a Contract with any public entity,and may not transact business with any public entity in Pvrnc$ of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on the convicted vendor list'. THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 11.1. This sworn statement is submitted to City of Sunny Isles Beath by Denis Atlanov, CEO and President lam,tnravAluai:a-..mme) for Atlanov LLC Dna came C en399 :A'.5.59 swam 4IDert:5511 whose business address is: 1990 NE 163rd Street, Suite 227, North Miami Beach. FL 33162 and Of applicable)its Federal Employer Idenitification number(FEIN)is 61-1771007 (If the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement .) 11.2. I understand that a"public entity crime'as defined in Paragraph 287.133(1 Xg), Florida Statutes,means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to,any Bid or Contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state of the United States and involving antitrust fraud,theft,bribery, collusion, racketeering, conspiracy,or material misrepresentation. 11.3. I understand that"convicted or"conviction"as defined in Para. 287.133(1 Xb), Florida Statutes,means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal a state trail court of record relating to charges brought by indictment or information after July 1, 1989.as a result of a jury verdict,non-jury trial,or entry of a plea of guilty or nob contendere. 11.4. I understand that an"affiliate"as defined in Para.287.133(1)(a),Florida Statutes,means: a.) predecesvor or successor of a person convicted of a public entity crime;a b.) Any entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term"affiliate"includes those officers, directors, executors,partners, shareholders,employees, members, and agents who are active in the management of an affiliate. Tice ownership by one person of shares constituting a controlling interest in another person,or a pooling of equipment or income among persons when not for fair Stun".9.r,o 2 of 7 10 v. AlLa rov ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Public Entity Crimes market value under an arm's length agreement, shall be a prime fade case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a pudic entity gime in Florida during the preceding 36 months shall be considered an affiliate. 11.5. I understand that a "person" as defined in Para. 287.133(1Xe), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "persons" includes those officers, directors, executives, partners, shareholders, employees,members, and agents who are active in management of any entity. 11.6. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Indicate which statement applies.) V Neither the entity submitting this sworn statement nor any of it's officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers,directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement,or one or more of its officers, directors, executives, partners, shaareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a pudic entity crime subsequent to July 1. 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearig Officer of the State of Florida. Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this swan statement on the convicted vendor list.(Attach a copy of the final order.) I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE)ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017. FLORIDA . STATUTES,FOR CATEGORY TWO OF ANY.CHANGE IN THE INFORMATION CONTAINED IN THIS FORM ft (Signature) f Dens Atlanov ill, 41((A442V (Printed Name) CEO and President (Title) /1 ! Sworn to and subscribedbefore me this I(� day of ! ` r`1 ,20d_by NTmtnig a�ilE) _hitt notary u tic •State of Florida Commission• FF 933386 y Signature:Notary Jnc-State of Florida '„F...�.•a` My Comm. Expires Jan 21.2020 � l..Ltlt GLOr " 'r- "'•°f,�,t„^ Bonded through National Notary Assn. Print or Type Cammssorhed Name Personally Known _ _ _ OR Produced Identification V Type of Identification Produced Oil- A?Iii y r/// -WV,-4-° _ un!fe 3 of 7 _ AtLanov ATLANOV, LIC • PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Equal Opportunity/Affirmative Action EQUAL OPPORTUNITY / AFFIRMATIVE ACTION City of Sunny Isles Beach ,.,. 18379 COWS avenue Sultry I1Ja Berl,Ft 33163 TeSe.Yrone:(305)947-0606 Far(305)9433113 EQUAL OPPORTUNITY/AFFIRMATIVE ACTION STATEMENT The contractors and all subcontractors hereby agree to a commitment to the principles and practices of equal opportunity in employment and to comply with the letter and spirit of federal, state, and local laws and regulations prohibiting discrimination based on race, color, religion, national region, sex, age, handicap, marital status, and political affiliation or belief. Signed: Tltie: CEO and President Firm: Atlanov LLC Address: 1990 NE 163rd Street, Suite 227 North Miami Beach, FL 33162 12 Alianov ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Conflict of Interest CONFLICT OF INTEREST City of Sunny Isles Beach 180 Com;Avenue •• •SOe� •� 3taiy Lies Beset.rt. 33160 ,•'a"',e• .. :eeanone:(30`_)9=747835 Far 13Ce_-19=43113 CONFLICT OF INTEREST STATEMENT The award of any rnnract heretrder is subject to the provisions of Chapter 112. Florida Saye Stawtes. Proposers must disclose with their Bids,the name of any dicer.erector.partner.assodae a agent who is also an oSeer a employee of the City of Sunny Isles Beach arts agencies. STATE OF1 n COUNTY OFFWpm,, ,/Writ BEFORE ME, the undersigned authority, personally appeared Denis Atlanov who yam , swan deposes,and saes: tat I am the CEO and President of Attanov LLC _ with a beat office in North Miami Beach and principal office in 18.2 The above named entity is submitting a Bid fa the City of Sunny Isles Beach, Bid No. 16-03-01 desaibed as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the intrmation contained in this Affidavit based upon his own knowledge. 18.3 The Afiam states that any one submittal for the above Bid is being submitted and that the above named entity has no frlanoial interest in cher entities submitting Bids far the same prciect 184 Neither the Mum nor the above named entity has directly a indirectly entered into any.ypuerrellt 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 wed the completion of negotatc s if necessary and execution of the Caaact for this project 18.5 Neither the entity nor its affiliates, rho any one associated with them.is presently ci.cpwded or otherwise inefig;de from participation in contract Ieting by any local can.a Federal Agency. 186 Neener the entity. rho its a.atiates. nor any one associated with them have any potential cordlit of interest due to any other dens,cornaos.or property interests for this project 1871 nerdy that no member of the erany's ownership or management is presently applying for any employee position a actively seeking an elected position with the City of Sunny Isles Beach. 18.81 certify that no member of the entity's ownership a management,a staff has a vested interest in any aspect of the City of Sunny Isles Beach. 189 In the event that a conflict of interest is identified in the provision of services,I,on behalf of the abate named ratty.Waal imnedately notify the City at Sunny Isles Beach. / / Dated thus 2J day d fr1/t ,r 2011; DPA/;" Af/AA/a✓ AFFIANT Print or Type Name and Title Sworn to and subscribed before me this_day of .2010. 0, Personally Known R Produced tan /0� hyped • 4l 399---/b/ 7( t1 -0 NOTARY PUBLIC STATE OF FLORIDA •�;,off„ VALERIE WOLIVER . , 'tor Notary Public•State ofFlodda I . amu` Comminlon♦FF 933386 < •,Fo:.r`dts: My Comm.Expires Jan 21,2020 Bonded Waugh Natioml Notuy Asp: 0 13 ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO.16-03-01 Dispute Disclosure Www r„ DISPUTE DISCLOSURE City of Sunny Isles Beach ' ^ stoic Cans 1*N'LY nun]eats Pack-L 33163 e.,. Tas.bne 1335)3:QDS Gat 1rs)3=33t 13 DISPUTE DISCLOSURE FORM Answer the following questions by placing a "X"after"Yes"or'NC. If you answer Y&, please explain in the space provided,or on a separate sheet attached to this form. 19.1. Has your fin or any of its offices, received a reprimand of any nature or been suspended by the Department of Profe tonal Regutatiors a any other regulatory agency a professional associations within the last five(5)years? Y6 NO X 19.2. Has your firm, or any merba of your firm, been dedared in default, thrninated or removed from a contract a job related to the services your firm provides in the regular can of bums within the last five(5) years? YE NO X 193. Has your firm had against it a Poal any request for equitable adjustment,contract claims, Bid protests, or litigation in the past five (5) years that is related to the service;your fum provide; in the regular can of bu S nes? YES NO X If yes, state the nature of the request fa equitable adjuustment, ca Bract claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the =retry amount of extended contract time involved. I hereby catty that all statement; made are true and agree and understand d that any misstatement or mvepreentation of falsification of facts shall he cause for forfeiture of right for further carideraton of this Eld for the City of army Isles Beach. Atlanov, LLC 03/30/2016 Frrn / Date /'%7, As Denis Atlanov,CEO and President Aust aced 4.41 Print or Type Name and Title 14 • A fTLanov @ ATLANOV, LLC PROPOSAL TO THE CITY OF SUNNY ISLES BEACH FOR MOTOR COACH TRANSPORTATION SERVICES: BID NO. 16-03-01 Anti-Kickback O 8. ANTI-KICKBACK I4 City of Sunny Isles Beach 1807C con:Ant= 34ma1Isis Best,FL 33160 or ,. Tee0.'Une:int)9470595 Far(30 )949-3113 ANTI-KICKBACK AFFIDAVIT STATE OF FLORIDA ) COUNTY OF �� 1'r Q ) I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid will be paid to any employees of the City of Sunny Isles Beach or its elected officals as a commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or by an officer of the corporation. By: Denis Atlanov Title: CEO and President The foregoing instrument was acknowledged before me this i? day of ��}QC(� 20/G , by (1d)''rc irri-4,1(o ✓✓ [name of person], as e. E O a t,of ere s,'d c 4 et [type of authority], for 4 4 A NO V L t_G [name of party on behalf of whom instrument was executed]. 6 INQTARY_SLAI4IPilEittE.; — +c ;a06, VALERIE WOLIVER -, ' Notary Public. Slate of Florida Notary Public — State of Florida +, j_` Commission I FF 933386 ;';Ftr`fid• My Comm.Expires Jan 21,2020 l/41ev�L /,9 Li lir- Print i,��„ Bonded through National Notary Assn: or Type Commissioned Name Personally Known OR Produced Identification Type of Identification Produced AI 43its-mT9-401-' 15