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<br /> s' ir, .
<br /> Y NON - COLLUSION AFFIDAVIT
<br /> ' = City of Sunny Isles Beach
<br /> •
<br /> ,',.1. .a . 18070 Collins Avenue
<br /> I sr,°-.Fop. Q+°r Sunny Isles Beach,FL 33160
<br /> ''*or s„+,''`' Telephone:(305)947-0606 Fax:(305)949-3113
<br /> STATE OF FLORIDA }
<br /> ;I )
<br /> COUNTY OF_a_Lau f, .
<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 /> -i'`9taS 6 t t.) 4 1 u6 LL L
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> a,6qJ G0ttt Y4.47f0 YL ,formed under the laws of G19/21Doe4'
<br /> (Type of Business)� (State)
<br /> , of which he is '1Q, t__)Ir .
<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 corp. -tion, 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•hei, neit er the undersigned, nor the person, firm or corporation named above In Paragraph
<br /> 10.2,has directly or Indirectly submitted said Bi. nr the ontents thereof,or divulged information or data relative thereto,to any association or
<br /> to any member or agent thereof.
<br /> Cu) D . 41,4-,�1>„, . 9„- - -Po L )7'"
<br /> AFFIANT'S NAME AFFIANT'S TITLE
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this OG day of 14,104.7 ,20 24)
<br /> Personally Known or Produced Identification •
<br /> Type of Identification
<br /> (Affix seal here) ` , V1s �p_ � P
<br /> NOTARY,PUBLIC(name printed or typ d)
<br /> Notary Public State of Florida
<br /> Javier Perez Ayala
<br /> ‘o•M1 +Y Isaion GG 924496
<br /> � Expires 10/21/2023
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<br /> DECEMBER 28,2010 1 of 8
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