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OµMY 4r s <br />OF I„ <br />NON -COLLUSION AFFIDAVIT <br />City of Sunny Isles Beach <br />_p`o* t 19010 Collins Avenue <br />9 fl-0Sunny Isles Beach, FL 33160 <br />cftr oF sot Telephone: (305) 947-0606 Fax (305) 949-3143 <br />STATE OF FLORIDA , <br />COUNTY OF Dad e ) <br />The undersigned being first duly sworn as provided by laW, deposes, and says: <br />This Affidavit is made with the <br />knowledge and Intent Thal it is to <br />be <br />filed with the Cily of Sunny Isles Beach <br />Clty Commission and <br />that it will be <br />relied upon by said County, in <br />any consideration which may give <br />to <br />and any action It may lake with respect <br />to this Bid. <br />The undersigned is authorized to make this Affidavit on behalf o(, <br />(,^5; r(1cooI, .zaiG <br />me of <br />Corporation, Pannership, Individual, etc.) <br />a, COY.�IOI'�L 6 f eh , formed under the laws of F/.-( d't' <br />gype of Business) (State) <br />o(which he is rre Pli�ISP ✓i/ <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 <br />This Bid is genuine and not collusive or a sham; the person, <br />to the knowledge of the <br />undersignedI have Themselves <br />solicited or employed anyone else <br />to solicit favofable action for this Bid by <br />the Cily, <br />also that no head of any <br />department or employee Therein, or any officer of the City of Sunny <br />Isles Beach, Florida Is directly Interested <br />(herein. <br />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, frm 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 of 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 />�vwtber�0 �ri'�? �fc�5,'C�v�� �✓� <br />AFFIANT'S NAME AFFIANT'S TITLE <br />41 <br />TAKEN, SWORN AND SUBS (BED TO BEFORE ME this � ay of / V �4 T/, / , 20-- <br />Personally Known (r//or Produced Identification <br />Type of Identification <br />�— <br />(Affix seal here) <br />NOTARt2MDLLG;tlha1ne printed or typed) <br />r7V OW <br />Sydney <br />yPublic <br />Horror Stale of Florida <br />a� Sydney Hartera <br />y a My Commission 00545075 <br />qa Cdr Expires 1010411025 <br />escreieea 29, 2010 1 of 8 <br />