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�SVr11iY IS�Fs <br />NON -COLLUSION AFFIDAVIT <br />vl i' City of Sunny Isles Beach <br />18070 Collins Avenue <br />i t Dai°*'S�t Sunny Isles Beach, FL 33160 <br />c. $," �Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />STATE OF FLORIDA <br />COUNTY OF MRS 1 0 1 <br />The undersigned being first duly swom 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 />SoQ'7«EAS7(`0t-k <br />(Name of Corporation, Partnership, Individual, etc.) <br />a, PO I M-1 I N G- —formed under the laws of FIL01211 <br />(Type of Business) (State) <br />of which he is 'OON M R A GO— <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, firth or corporation named above in Paragraph 10.2 has not colluded, conspired, <br />connived or agreed directly or indirectly with any proposers or person, firth 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, firth 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 />k -A I LE 5 G� 04011 r 6iaEc - S � a +w�livtr✓? IW <br />AFFIANT'S NAME AFFIANT'S TITLE <br />.14 <br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this' -Z day of b1 ie122 .EY 2Q <br />Personally Known or Produced Identification <br />Type of identification <br />(Affix seal here)���,� LX/v <br />NOTARY PUBLIC (name printed or typed) <br />�piir'iyi•. SUSAN A.UIETER <br />R'.. <br />'. +• Notary public - State of Florida <br />Commission A GG 189901 <br />My Comm. Expires May 29, 2022 <br />Bonded through National Notary Assn. <br />DECEMBER28,2010 <br />