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'T*or tgH •' <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 />STATE OF FLORIDA ) <br />county of 9)\o*tafd ) <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 willbe <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 />Cyff-f.O^pGon mafdcr llP <br />tio'n,(Name of Corporation,Partnership,Individual,etc.) <br />a,UP <br />(Type of Business) <br />of which he is PaHTif/ <br />.,formed under the laws of f-)Or >£J <br />(State) <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 />"'[••:.'•A ^ <br />AFFIANT'S NAME ' <br />J <br />TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this ^day of PCb TH^rM 2Q_i3_ <br />Personally Known •/ <br />Type of identification <br />(Affix seal here) <br />December 28,2010 <br />or Produced Identification <br />Pacfftcc <br />AFFIANT'S TITLE <br />d/Mt (IP— <br />"ARY PUBLIC (name printed orNOTARY typed) <br />38