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<br />NON -COLLUSION AFFIDAVIT
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<br />City of Sunny Isles Beach
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<br />18070Collins Avenue
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<br />Sunny Isles Beach, Ft. 33160
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<br />Telephone: (305) 947-0606 Fax: (305) 9493113
<br />STATE OF FLORIDA )
<br />COUNTY OF
<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 />(Name dt Corporation, Partnership, Individual, etc.)
<br />a, Jf l Ok-f' G pAIJ5 for
<br />Il med under the laws of rl,_ `H ILAr
<br />(T� ype of Business) �
<br />(State)
<br />of which he Is _ &,e -yl'
<br />(Sole Owner, Partner, President, etc.)
<br />Neither the undersigned nor any person, firm, or corporation named In above Paragraph 102, 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 />�) ` II.Q,(�/V�VbU1L1n% lf�Jrl�l�.Y
<br />AFFimra NAME AFFIANTS TITLE
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this l day of , 2M
<br />Personally Known or Produced Identification
<br />Type of Identification� 1X-, �.cc rl��_-�V . j 13 =-W 369
<br />(Affix seal here)
<br />• IV, DIANA MARIA FERRARA
<br />4Q, ' Notary Public -State of Fioilde
<br />* Commission ti HH 210986
<br />�� �( `���: My Commission Expires
<br />December 26, 2026
<br />DecEmBER 28, 2010
<br />sta m:- .mom Ptr--'�
<br />1101uc- f f—q
<br />NOTARY PUBLIC (name printed or typed)
<br />
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