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<br />STATE OF FLORIDA ]
<br />CQVNTY OF Jefleregn Parish
<br />The undersigned being ftt duly swam a1r provided by law, deposes, and says:
<br />This Atidavit is made with the knowledge and 'rnient thP1 H is to be filed with the City of Sunny Isles Beach City Commission lrnd t,'1ai fl w1U be
<br />raliad upon by said County. in any canslideration which may give to and any eciion it may tate with respect to This RFP.
<br />The undersigned is authorized to make this Affidavit on behalf of,
<br />DRC Emergency Services, LLC
<br />(Nance o Corporation, Partnership. Individual, e1c.)
<br />a Limited Liability Company , formed under the lays of Alabama
<br />(Type of Business) (Slate)
<br />of which he is Vice PresidenilSecretaryfTreasurer
<br />(sols Owner, Pariner, President,eic.)
<br />Nefiner the undersigned nor any person, firm, or corpoWion narnod atlave nor anyone else to the knrnviedge at the undersigned, have
<br />fnem9elwe5 soliatt=_d or employed anyone else to solicit favorable aclion :or this RFP by the City, also That no head of any daps #mens
<br />Or em{llOyee iheretn, or any officer of the City fl1 Sunny Islas Beam, Flarida is directly interested therain.
<br />This RFP is genuine end not milusive or a sham; the person, ff.m or corporation named above has not ualtuded, conspiled, connived or
<br />agreed dlrecAty or indiredly, with any proposers or person, firm ar corporation, to pull in a sham RFP, or that SuCh person, firm or
<br />corporation, shell refrFin from Binding, and has not in any manner, directly or indirectly, saughi by agreement or cattusion, or Cor1L'ilunicatio•'1
<br />or Conference with any psrsnn, firm or oorportion, to fix the prices 61 61.1d Bid or Bids 01 any other prapatom; and all statements
<br />rzlntained in the RFP or RFP's de5rdbed ahove true; and t,,rther; neither the undersigned, nor the person, nm1 or corporation named
<br />above has dirCCUy or indirectly submitted 5vid RFP or the consents thereof, or divulg inforTn0on or lative thereto, to any
<br />associaiion or to any member or agent thereof.
<br />Klisty Fuentes Vice President/Secr-sta reasur
<br />&P
<br />AFFIANTS NAME AFFIAwrs TITLE
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this —day of _ _ a 21118
<br />Persanany 15no- .1 or Produced Identiicaiion
<br />Typ' of idenfifita=Jon
<br />(Affix seal here)
<br />AY Ab DES RO CHES
<br />NOTARY PUBLIC
<br />State of Louisiiarta, Bar No. 19550
<br />My Conimisaion is for life
<br />1814Y PUBLIC (name prided or typed)
<br />1of10
<br />115
<br />NON -COLLUSION AFFIDAVIT
<br />City of $unny Isles Beach
<br />-
<br />16070 Callin 5 Aveaue
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<br />tir .�� a�►'�� ..`'
<br />S.rniy 15165 R8-ich, F I 33160
<br />�i+�
<br />TrlGplresat.(30j)947-OW5f•(MS) 949-3113
<br />STATE OF FLORIDA ]
<br />CQVNTY OF Jefleregn Parish
<br />The undersigned being ftt duly swam a1r provided by law, deposes, and says:
<br />This Atidavit is made with the knowledge and 'rnient thP1 H is to be filed with the City of Sunny Isles Beach City Commission lrnd t,'1ai fl w1U be
<br />raliad upon by said County. in any canslideration which may give to and any eciion it may tate with respect to This RFP.
<br />The undersigned is authorized to make this Affidavit on behalf of,
<br />DRC Emergency Services, LLC
<br />(Nance o Corporation, Partnership. Individual, e1c.)
<br />a Limited Liability Company , formed under the lays of Alabama
<br />(Type of Business) (Slate)
<br />of which he is Vice PresidenilSecretaryfTreasurer
<br />(sols Owner, Pariner, President,eic.)
<br />Nefiner the undersigned nor any person, firm, or corpoWion narnod atlave nor anyone else to the knrnviedge at the undersigned, have
<br />fnem9elwe5 soliatt=_d or employed anyone else to solicit favorable aclion :or this RFP by the City, also That no head of any daps #mens
<br />Or em{llOyee iheretn, or any officer of the City fl1 Sunny Islas Beam, Flarida is directly interested therain.
<br />This RFP is genuine end not milusive or a sham; the person, ff.m or corporation named above has not ualtuded, conspiled, connived or
<br />agreed dlrecAty or indiredly, with any proposers or person, firm ar corporation, to pull in a sham RFP, or that SuCh person, firm or
<br />corporation, shell refrFin from Binding, and has not in any manner, directly or indirectly, saughi by agreement or cattusion, or Cor1L'ilunicatio•'1
<br />or Conference with any psrsnn, firm or oorportion, to fix the prices 61 61.1d Bid or Bids 01 any other prapatom; and all statements
<br />rzlntained in the RFP or RFP's de5rdbed ahove true; and t,,rther; neither the undersigned, nor the person, nm1 or corporation named
<br />above has dirCCUy or indirectly submitted 5vid RFP or the consents thereof, or divulg inforTn0on or lative thereto, to any
<br />associaiion or to any member or agent thereof.
<br />Klisty Fuentes Vice President/Secr-sta reasur
<br />&P
<br />AFFIANTS NAME AFFIAwrs TITLE
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this —day of _ _ a 21118
<br />Persanany 15no- .1 or Produced Identiicaiion
<br />Typ' of idenfifita=Jon
<br />(Affix seal here)
<br />AY Ab DES RO CHES
<br />NOTARY PUBLIC
<br />State of Louisiiarta, Bar No. 19550
<br />My Conimisaion is for life
<br />1814Y PUBLIC (name prided or typed)
<br />1of10
<br />115
<br />
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