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SJ�yNY tst6 <br />O� Je <br />F y NON -COLLUSION AFFIDAVIT <br />� n <br />City of Sunny Isles Beach <br />ft"aY2 a' a <br />• 181170 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br />hyf' 99�• FL�R` 4� <br />of su" *a� 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 />(R—ai6e of Corporation, Partnership, in vidual, etc.) <br />a '4�11, formed under the laws of e4 <br />(Type of Business) (State) <br />of which he is�lX��'` <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 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 />AFFIAN AFFIANT'S TITLE <br />V <br />TA EN, SWORN AND SUBSCRIBED TO BEFORE ME this day of /, <-7— 2 <br />WX <br />Personally Known or Produced Identification <br />Type of identification �� ^ !1" Alt t3; n' LILEL'X& <br />(Affix seal here) <br />I>�w.faalln <br />&**" Mum <br />DECEMSER26,2010 <br />