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40
<br /> L.
<br /> IV
<br /> 11110
<br /> Op SUNNY is,
<br /> E:d
<br /> r �Ix NON - COLLUSION AFFIDAVIT
<br /> r A City of Sunny Isles Beach
<br /> 18070 Collins Avenue
<br /> 14 '''''•
<br /> C
<br /> F 99'•i o��4:r Sunny Isles Beach,FL 33160
<br /> ''0, sus•" Telephone:(305)947-0606 Fax:(305)949-3113
<br /> 111,
<br /> 101,
<br /> STATE OF FLORIDA )
<br /> COUNTY OF MIAMI
<br /> 41110
<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 /> iiiir 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 t half of,/ ch
<br /> .
<br /> I► /4/7,�� (hSi, c.
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> lir
<br /> a, � - dt74-PQ{4-.10 K ,formed under the laws of ih(ie*k
<br /> iiir (Type of Business) (State)
<br /> it �e"S I c e( �1 .
<br /> of which he is
<br /> (Sole Owner,Partner,President,etc.)
<br /> 111,
<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 /> Air 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 /> iso
<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 /> MI 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 /> go 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 /> 411Y 7
<br /> lir '')6/-er/4'S AC1-7.(2 - . .P.s&.,,,e/
<br /> AFFIANT'S NAME AFFIANTS TITLE
<br /> TAKEN,SWORN AND S SCRIBED TO BEFORE ME this day of -_ et/C" ,20'tel
<br /> Personally Known or Produced Identification 7 p Tt_. ,,,EZ' 411
<br /> Type of identification r + "'�, Notary Public -'�o r!prlp
<br /> ti :. ,�•i Commissi -v 3GB�C
<br /> e•-i MyCOmm.E . ., a 2r�g
<br /> (Affix seal here) 1
<br /> �?` . ,throve %;;;:•,bz
<br /> appmitv,ormorat
<br /> 00.,11111
<br /> illiP OTARY P printe- • typed)
<br /> 4100
<br /> 40 ,..:;„..„„i.,,,,,,,,„,, LINET SANCHEZ
<br /> o -
<br /> ^� Notary Public-State of Florida
<br /> 41111 i• c„, •` Commission#GG 159830
<br /> g `: °.- Comm.Expires Mar 4,2022
<br /> O,F Bonded through National NotaryAssn.
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<br /> tar DECEMBER 28,2010 1 of 8
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