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c2,.04 NY is, JW
<br /> k , -(1/F NON — COLLUSION AFFIDAVIT
<br /> City of Sunny Isles Beach
<br /> '''.••'n� "" 18070 Collins Avenue
<br /> c,r •F O0. �o
<br /> Sunny Isles Beach,FL 33160
<br /> OF +u" Telephone:(305)947-0606 Fax:(305)949-3113
<br /> STATE OF {&e.:1 0 c.(tc.f )
<br /> COUNTY OF Ccst/W4L I I ) )
<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 /> 5 ,4,4-L;4 k
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> a, C 6 V pC.MCCLI• Nl<v
<br /> i 0" ,formed under the laws of !Cm � I
<br /> rt r (Type f Business) (State)
<br /> of which he is l..kr C7 I-1 rtcagLiq.I OcAk,e_Ar–
<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.
<br /> TSbL SJ zc G111 f" - •t"tt . —
<br /> AFFIANT'S NAME AFFIANTS TITLE
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this Aa day of rn-1 ,2017
<br /> Personally Known >( or Produced Identification ,
<br /> Type of identification
<br /> (Affix seal here)
<br /> SA)e..., /OVA it-
<br /> NOTARY PUBLIC(name printed or typed)
<br /> STEVE.RISTAU
<br /> NOTARY PUBLIC
<br /> Kentucky,State At Large
<br /> I.D.0 543406
<br /> My Commission Expires 101713019
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