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SvµNr <br /> 1stF <br /> • <br /> 1. i z NON - COLLUSION AFFIDAVIT <br /> Kman <br /> City of Sunny Isles Beach <br /> 18070 Cow Avenue <br /> ''•;torso'+` Sunny Isles Beach,Ft 33160 <br /> "r or sv•l ,' Telephone:(305)947-0606 Fax:(305)949-3113 <br /> STATE OF FLORIDA <br /> COUNTY OF /11/414/ 'k„ <br /> The undersigned being first duly sworn 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 /> reed 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 /> j-4Mi 64/ iti u ti 144 )t 2.n P iir <br /> (Name of Corporation,Partnership,Individual,etc.) <br /> 4f�� `^ <br /> a, '4'z«C-11)4.—.formed under the laws of 74,15N <br /> (Type of Business) (State) <br /> of which he is /tit 4CIACI-fr <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. L <br /> lTd S46 1214§4. raetekrifi <br /> AFFIANT'S NAME AFFIANT'S TITLE <br /> TAKEN.SWORN AND SUBSCRIBED TO BEFORE ME this 1 day of)CCe1M`k.r •20§■ ? <br /> Personally Known or Produced Identification • <br /> Type of identification <br /> One <br /> (Affixsefolt4ftrA, ELiNAREYES ��P- <br /> * • t MY COMMISSION t FF 054581 <br /> EXPIRES:NoVembef 29,2017 a` -Y : (name printed or typed) <br /> ntl1 BolldedStrvBed$H1'ary U nica <br /> DECeuaER 28.2010 1 of 10 <br />