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NON - COLLUSIVE AFFIDAVIT <br />State of ) <br />)ss <br />County of <br />deposes and says that: <br />being first duly sworn, <br />(1) He /she is the(Owner, Partner, Officer, Representative or Agent) of the <br />Bidder that has submitted the attached Bid; <br />(2) He /she is fully informed respecting the preparation and contents of the <br />attached Bid and of all pertinent circumstances respecting such Bid; <br />(3) Such Bid is genuine and is not a collusive or sham Bid; <br />(4) Neither the said bidder nor any of its officers, partners, owners, agents, <br />representatives, employees or parties in interest, including this affiant, have <br />in any way colluded, conspired, connived or agreed, directly or indirectly, <br />with any other Bidder, firm, or person to submit a collusive or sham Bid in <br />connection with the Work for which the attached Bid has been submitted; <br />or to refrain from bidding in connection with such Work; or have in any <br />manner, directly or indirectly, sought by agreement or collusion, or <br />communication, or conference with any Bidder, firm, or person to fix the <br />price or prices in the attached Bid or of any other Bidder, or to fix any <br />overhead, profit, or cost elements of the Bid price or the Bid price of any <br />other Bidder, or to secure through any collusion, conspiracy, connivance, or <br />unlawful agreement any advantage against the City of Sunny Isles Beach, <br />or any person interested in the proposed Work; <br />(5) The price or prices quoted in the attached Bid are fair and proper and are <br />not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part <br />of the Bidder or any other of its agents, representatives, owners, employees or parties in <br />interest, including this affiant. <br />Page 9 of 17 <br />Dental, Life, LTD, Vision RFP.Doc <br />