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Snr1NT r3( J
<br />OF
<br />NON-COLLUSION AFFIDAVIT
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />n% • Sunny Isles Baach, FL 33160
<br />oF su "09 Telephone: (305) 947-0606 Fax: (305) 949-3113
<br />S7ATE OF FLORIDA )
<br />COUNTY OF VQ1W1 D4L Lh)
<br />The undersigned being first tluly sworn as provided bylaw, 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 />0(t *3.!) Set%t- 14,(4{jt.s cute ,_(tif�r P. C.
<br />(Name of Corporation, Partnership, Individual, etc.)
<br />a, C b ✓ F• r •^ ,formed under the laws oF_�
<br />(Type of Business) (Slate)
<br />o(whlch he is %yC•M�J
<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 Btd by the Cify, also that no head of any
<br />department or employee (herein, 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 />AFFIANT'S NAME AFFIANT'S TITLE
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this �� tlay of 'Y"�SJ•' k )QJ" �1 , 2�
<br />Personally Known '6. or Produced Identification
<br />Type of identification
<br />(Affix seal here)
<br />`s;�'"""kfi._ AMY LYNN WITKOWSKI
<br />�r;,1µ�\, Notary Publk-State otElaida
<br />occeuaenze, zoto
<br />C11
<br />Commisslon M GG 181673
<br />My Comm, Expires Feb I, 7017
<br />vended Through National Notary Assn,
<br />NOTARY I3UBLIC (name printed or typed)
<br />
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