|
O�SV{dNr is, �SB
<br />a F
<br />yF 99J• FLOp\O y�r
<br />CITY Or SUN ^a0
<br />STATE OF FLORIDA )
<br />COUNTY OF0"WW )
<br />NON -COLLUSION AFFIDAVIT
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />Sunny Isles Beach, FL 33160
<br />Telephone: (305) 947-0606 Fax: (305) 949-3113
<br />The undersigned being first duly swom as provided by law, deposes, and says:
<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, Partnership, Individual, etc.)
<br />a,[.��5 rif c'Y 7�r(� formed under the laws of 4-1t)-,ort,i
<br />(Ty0e of Business) (State)
<br />of which he is JL .sI d' 0+
<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�rrib�e or agent th�i �4 _
<br />AFFIANT'S NAME AFFIA TT'S TITLE
<br />7/ -
<br />TAKEN,
<br />/-
<br />TAKEN, SWORN ANDSUBSCRIBED TO BEFORE ME this day of; I� 200A,,3
<br />Known or Produced Identification
<br />Type of identification
<br />(Affix seal here)
<br />±tYP'• MICHELE WILSON
<br />Notary Public - State of Florida NOTARY PUBLIC (name printed or typed)
<br />Commission # HH 219570
<br />My Comm. Expires May 8, 2026
<br />Bonded through National Notary Assn.
<br />DECEMBER 28, 2010
<br />
|