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SV 4NY IS(E <br />\\ <br />0" <br />Sf yyJ FlOFSO .y <br />T ANV <br />Y or sv�� <br />STATE OF FLORIDA <br />COUNTY OF 4)6 ) <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 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 />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 />v J / <br />(Name of orporatlon, P rtnershlp, Individual, etc.) <br />a, h6A , %,At �tu( l P c.— , formed under the laws of t <br />(Type of-Business) (State) <br />l L -� <br />of which he is = Co I w i I I I, Gi _ ilit --)1 '0 A e a <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 membe[pr agent thereof. <br />AFFIAN 'S NAME AFFIANT'S TITLE <br />TAKEN, SWORN AND BSCRIBED TO BEFORE ME this day of nUiCl 20 <br />Personal) Known " or Produced Identification <br />Y <br />Type of identification <br />(Affix seal here) <br />NOTA PUBLIC (name printed or typed) <br />\.aOANA D.�Bn��'�isi <br />a ��Mtv41SS /py <br />ember 6 <br />a. • ®• wee <br />#pp 887204 a <br />e F <br />oy9� <br />�o 9P "?ded thO ••" �0� <br />'i• � °�•�o�oiaruSeri��: <br />DECEMBER28,2010 1 of <br />STM <br />