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�4ot4NY <br />:7 NON -COLLUSION AFFIDAVIT <br />V � _ <br />City of Sunny Isles Beach <br />P 18070 Collins Avenue <br />e * s �cn `� Sunny Isles Beach, FL 33160 <br />c rr <br />of Sufi ° Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />STATE OF FLORIDA ) <br />COUNTY OF <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 />�-1� c>�as ct �(� l ►� �� ✓l � � �L L <br />(Name of Corporation, Partnership, Individual, etc.) <br />a,%b(�°� ��K7YAUTT� ✓1i , formed under the laws of <br />(Type of Business) (State) <br />of which he is `�� t� )-,— <br />(Tole <br />y( ole 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 corp ation, o x the prices of said Bid or Bids of any other proposers; and all statements contained in <br />the Bid or Bids described above true; a fu he , neit er the undersigned, nor the person, firm or corporation named above in Paragraph <br />10.2, has directly or indirectly submitted said Bi r the �ontents 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 196 day of 201 <br />Personally Known or Produced Identification , <br />Type of identification <br />(Affix seal here) <br />off Notary Public State of Florida <br />« Javier Perez Ayala <br />y My Commission GG 924496 <br />of 0. Expires 10/21/2023 <br />J v 2,j�-764 <br />NOTARY PUBLIC (name printed or typ d) <br />DECEMBER 28, 2010 1 of 8 <br />