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Sa�NY rs�
<br />Off'`
<br />NON -COLLUSION AFFIDAVIT
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />F F 60R y Sunny Isles Beach, FL 33160
<br />C/TY OF 5 t3 ANO Telephone: (305) 947-0606 Fax: (305) 949-3113
<br />STATE OF FLORIDA )
<br />COUNTY OF l"OW64
<br />The undersigned being first duly swom 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✓ 06 1,- V1%rcrs' 'TF U 0 k)AA,r" Co. -1—LA C
<br />(Name of Corporation, Partnership, Individual, etc.)
<br />a, _5*d? CA.T.'J 0 rPi4t4 )i%AC , formed under the laws of
<br />I (Type of Business) (State)
<br />of which he is S4LB Q. its 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 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 />I. '0 l�uss5 D.rw
<br />AFFIANT'S NAME AFFIANT'S TITLE
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this C r1at, of C' • on2
<br />Personally Known �/� or Produced Identification
<br />Type of identification _ >l D/ '
<br />(Affix seal here)
<br />------------
<br />Y v ANGELA PAULINO
<br />Notary Public - State of Florida
<br />Commission # HH 233411
<br />„•oF "'' My Comm, Expires Feb 27, 2026
<br />DECEMBER 28, 2010
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