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<br /> `004 NY isr``i
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<br /> �. NON- COLLUSION AFFIDAVIT
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<br /> City of Sunny Isles Beach
<br /> •' �' _ 18070 Collins Avenue
<br /> > it c'i'., o"0 ' Sunny Isles Beach,FL 33160
<br /> o. s..'~ Telephone:(305)947-0606 Fax:(305)949-3113
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<br /> STATE OF FLORIDA )
<br /> COUNTY OF I
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<br /> The undersigned being first duly sworn as provided by law,deposes,and says:
<br /> 4 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
<br /> authorized'to/make this Affidavit4&si
<br /> onbfhalf of .
<br /> �' de//7e, c-4/7 _i_ei c.
<br /> (Name of Corporation.Partnership,Individual,etc.) '
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<br /> a, (.-,47(PD(�='1O K ,formed under the laws of i‘i/(.1A�
<br /> tar _ (Type of B siness) (State)
<br /> filIP t( f St�f
<br /> of which he is �{ .
<br /> (Sole Owner,Partner,President,etc.)
<br /> (64
<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 /> Q . 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 /> MP corporation,shall refrain from Bidding,and has not in any manner,directly or indirectly,sought by agreement or collusion,or communication
<br /> A.: 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 /> r 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 /> illI to any member or agent thereof.
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<br /> AFFIANTS NAME AFFIANTS TITLE
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<br /> 20;TAKEN,SWORN AND S SCRIBED TO BEFORE ME this ' /"C
<br /> day of " ,20 H..
<br /> Personally Known J or Produced Identification SET 5-.,•.n"cZ
<br /> t Notary Public- 5 D'Fkelt
<br /> Type of identification ,
<br /> 1 � 1 cDrttrtrissi::..--,3_ .3Seac
<br /> *Comm EN:
<br /> tir (Affix seal here) ��. A'; 0` Qroc
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<br /> 'OTARY P ■ print- typed)
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<br /> ,•�;1.. LINET SANCHEZ
<br /> _. 1'= Notary Pudic-State of Aaida
<br /> lir ,� iiti . Commission 8 GG 159830
<br /> My Comm.Evires Mar 4,2022
<br /> 4111F ��an.. Baledthrough Natio lNotaryAssn.
<br /> 3
<br /> rDECEMBER 28.2010 1 of
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