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NON-COLLUSION AFFIDAVIT
<br />City of Sunny lsles Beach
<br />18070 Collins Avenue
<br />Sunny lsles 8each, FL 33160
<br />Telephone: (305) 947-0606 Faxi (305) 949-3'l'13
<br />STATE OF FLORIDA )
<br />COUNTy OF P>r "w>u a-l
<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 lsles 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 />Ihe undersigned is authorized to make this Affidavit on behalf of,
<br />-t h€- R?, '\r{I TO.2
<br />(Name of Corporation, Pannership,lndividual, etc.)
<br />VLt- zLlra Nzr.alr:, t].._r
<br />tTZ r .\rr , ,\e". formed under the laws of F Lcr,aa-
<br />(Type of Business)
<br />of which he is t) ic o l),1 .-,; A elrf
<br />(State)
<br />Neither the undersigned nor any person, firm, or corporation named above nor anyone else to the knowledge of the undersigned, have
<br />themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any derartment or
<br />employee therein, or any officer of the Cily of Sunny lstes Beach, Florida is directly interested therein.
<br />This Bid is genuine and not collusive or a sham; the person, firm or corporation named above has not colluded, conspired, connived or agreed
<br />directly or indirectly with any proposers or person, flrm or corporation, to put in a sham Bid, or that such person, firm or corporation, shall
<br />ref.ain from Bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication or conference with
<br />any person, firm or corporation, to fix the prices of said Bid or Bids of any other proposers; and all statements contained in the Bid or Bids
<br />described above true; and funher; neither the undersigned, nor the person, firm or corporation named above has directly or indirecfly
<br />submitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or to any member or agent
<br />thereof.
<br />*)d,c. PeortL";
<br />(Sole Owner, Partner, President, etc.)
<br />AFFIANT'S TITLE
<br />!
<br />AFFIANT'S NAME
<br />(Affix seal here)
<br />TAKEN, SWoRN AND SUBSCRIBED TO BEFORL tvtr tnis.*Oay or-/'
<br />Personally Known LZ or Produced ldentrfication _:
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<br />BIBI K^TEEU HACX
<br />li.PIJD state Florid.Notary
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<br />NOTARY PUBLIC (name printed or typed)
<br />of
<br />Comftisrion 20E52
<br />Expir€s
<br />Natioo,l
<br />1of 8
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