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la <br /> is <br /> ® SOrrN♦trrE <br /> ® E/ -.," ` -\=O NON - COLLUSION AFFIDAVIT <br /> •a ' _7:. r : City of Sunny Isles Beach <br /> ' Y:- ' 18070 Collins Avenue <br /> ® '. ''•nots C <br /> o Sunny Isles Beach.FL 33160 <br /> r"•o. sus^r� Telephone:(305)947-0606 Fax(305)949-3113 <br /> a <br /> ® STATE OF FLORIDA ) <br /> ® tyl RFlt – ) <br /> COUNTY OF p*P FL- ) <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 /> ® Snac�Ic ( wte--) 7-L <br /> ® (Name of Corporation,Partnership,Individual,etc.) �1 �n <br /> ® a }—OD� 2,rU(CC- formed under the laws of nortGLC!. <br /> (Type of of Business) (State) <br /> Gil® of which he is IQt(� l <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 /> 1=5-1 k l(rreC, 1-f0( ✓ &cat vt, --- --11-6-weC <br /> C / / <br /> AFFIANTS NAME , �' w <�. AFFIANTS TITLE l <br /> \„ TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this, day of(� .200F — <br /> ® 71/4 Personally Known or Produced Identification it..1 ; <br /> bType of identification p • //li— <br /> ® / - <br /> (Affix seal here) <br /> ® •TARP P = na printed or typed) <br /> Nv L1N RODRIGUE2 <br /> ® P FRry ''',c..State of Forida <br /> Ia._:0(5 mot:01a ::;*.on?FD D67ti7;2201 <br /> ® ( _ . Ujnm 3 ..a <br /> CO IP <br /> DECEMBER 28.2010 1 of 7 <br /> 0 <br />