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� �- •L NON- COLLUSION AFFIDAVIT
<br /> City of Sunny Isles Beach
<br /> 18070 Collins Avenue
<br /> yP 9?*f 40 O, '• Sunny Isles Beach,FL 33160
<br /> 'of susus" Telephone:(305)947-0606 Fax:(305)949-3113
<br /> STATE OF FLORIDA
<br /> COUNTY OF
<br /> `AtO)
<br /> The undersigned being first duly sworn as provided by law,deposes,and says:
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<br /> This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be
<br /> relied upon by said County,in any consideration which may give to and any action it may take with respect to this Bid.
<br /> The undersigned is authorized_to_make_this Affidavit-on behalf-of;
<br /> (Name of Corporation,Partnersll'p,Individual,etc.)
<br /> a, Ce,, sT i OIJ ,formed under the laws of F1.49 it:b 1:1-
<br /> (Typelof Business) (State)
<br /> of which he isl�I[til ' r"4'0-4G.1,41V B AP► (C.F4
<br /> 2
<br /> (Sole Owner,Partner,President,etc.)
<br /> Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10.2, nor anyone else to the knowledge of the
<br /> undersigned, have themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any
<br /> department or employee therein,or any officer of the City of Sunny Isles Beach,Florida is directly interested therein.
<br /> This Bid is genuine and not collusive or a sham;the person,firm or corporation named above in Paragraph 10.2 has not colluded,conspired,
<br /> connived or agreed directly or indirectly with any proposers or person,firm or corporation,to put in a sham Bid,or that such person,firm or
<br /> corporation,shall refrain from Bidding, and has not in any manner,directly or indirectly,sought by agreement or collusion,or communication
<br /> or conference with any person,firm or corporation,to fix the prices of said Bid or Bids of any other proposers;and all statements contained in
<br /> the Bid or Bids described above true; and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph
<br /> 10.2,has directly or indirectly submitted said Bid or the contents thereof,or divulged information or data relative thereto,to any association or
<br /> to any member or agent thereof.
<br /> % • ► t Z) G�%J
<br /> AFFIANT'S NA,' = AFFIANT'S TITLE
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 14 ay of4 7 ,2�
<br /> Personally Known X or Produced Identification •
<br /> Type of identification
<br /> (Affix seal here) �aV• i
<br /> NOTA- • BLIC(,ame printer o'typed)
<br /> .ocrsvpw, Notary Public State of Florida
<br /> Kaney Ratteray
<br /> My Commission FF 978529
<br /> 'tor aF Expires 04/04/2020
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<br /> DECEMBER 28,2010
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