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<br />NON-COLLUSIVE AFFIDAVIT
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<br />State of ~lo(Z- (O!- )
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<br />County of MW-{\-~~
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<br />-f.pF-t~A ~VI i-JD ,- 9--C \ Uc::lL.
<br />and says that:
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<br />being first duly sworn, deposes
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<br />(I) He/she is the (Owner, Partner, Officer, Representative or Agent) of the Bidder that has
<br />submitted the attached Bid;
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<br />(2) He/she is fully informed respecting the preparation and contents of the attached Bid and
<br />of all pertinent circumstances respecting such Bid;
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<br />(3) Such Bid is genuine and is not a collusive or sham Bid;
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<br />(4) Neither the said bidder nor any of its officers, partners, owners, agents, representatives,
<br />employees or parties in interest, including this affiant, have in any way colluded, conspired,
<br />connived or agreed, directly or indirectly, with any other Bidder, firm, or person to submit a
<br />collusive or sham Bid in connection with the Work for which the attached Bid has been
<br />submitted; or to refrain from bidding in connection with such Work; or have in any manner,
<br />directly or indirectly, sought by agreement or collusion, or communication, or conference with
<br />any Bidder, firm, or person to fix the price or prices in the attached Bid or of any other Bidder, or
<br />to fix any overhead, profit, or cost elements of the Bid price or the Bid price of any other Bidder,
<br />or to secure through any collusion, conspiracy, connivance, or unlawful agreement any
<br />advantage against the City of Sunny Isles Beach, or any person interested in the proposed Work;
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<br />(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by
<br />any collusion, conspiracy, connivance, or unlawful agreement on the part of the Bidder or any
<br />other of its agents, representatives, owners, employees or parties in interest, including this
<br />A [fiant.
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<br />SIGNATURE OF AFFIANT
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<br />.~ SAJll'--O -M(~
<br />(Printed or Typed Legal Name of Affiant)
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<br />State of 'Plo\<..i(,4l,. County of M\Al.-(.( - ~
<br />Sworn to and subscribed before me this Z 4- day of -APl'2- { L-
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<br />,2007bY~
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<br />EDEN JEAN-CHARLE &
<br />Public. State of F Ic~ja
<br />: . ~My Commission Ex~,ir.;s Apr 21, 2009
<br />Notary Sea '.' ,4 Commission # DO ~214B3
<br />,,:t,.'ff,r,~'t" Bonded By I>!ational ~iotary Assn.
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<br />fCc/PiA .. J PFLvt '"' C- ~f(e':::::'
<br />Notary's Name Printed, Stamped or Typed
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<br />Personally Known:
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<br />or Produced Identification ~ Type: P,L, iF H 460 - ro7 - S ~ - r::AC:>-D
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<br />Page 9 of9
<br />RFQ 07-03-01 Engineering Srvs Bridge Revised (Addendum I).doc
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