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rs<F�e <br />SJNNY <br />O� <br />;. <br />NON -COLLUSION AFFIDAVIT <br />V — Z <br />City of SunnyIsles Beach <br />",D .;-��>•.,so� t <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33100 <br />0 <br />or 500 "� <br />Telephone: (305) 947-0800 Fax: (305) 949.3113 <br />STATE OF FLORIDA ) <br />COUNTY OF A no R r <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 />L _ (�1/rl!/.yf?,6��P.Y1 •�s%Gad"L'� <br />(Name of Corpbration, Partnership, Individual, etc.) <br />a, fn�}�� �-� S �� formed under the laws of el - <br />(Type of Business)— (State) <br />of which he is Ca, r --hi G, 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 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 ail 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 />AF NT'S NAME AFFIANT'S TITLE <br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this � day of 20 <br />Personally Known or Produced Identification <br />( V ; <br />Type of identification �yY�ork&e �J�` (`[at�l <br />d ZCWV— <br />(Affix seal here) Isabel Foaranu <br />.0NOTARY PUBLIC <br />STATE OF FLORIDA <br />1 Comm# GG915775 <br />Expires 9/23/2023 <br />1 <br />DECEMBER28,2010 ` <br />—XU&A3-7�"aVVD <br />NOTARY PUBLIC rinted or typed) <br />C'4-0 -- 13- 0( <br />