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<br />NON -COLLUSION AFFIDAVIT
<br />+` (: City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />1F ➢J. F�p0.�0 S,pr Sunny Isles Beach, Fl- 33160
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<br />c' r of suK !� Telephone: (305) 947-0608 Fax: (305) 949-3113
<br />STATE OF FLORIDA
<br />COUNTY OF Wmoi-- ' -.
<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 fled 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 />Gey�,ktp. LU!,
<br />(Name of Corporation, Partnership, I dMcluai, etc.)
<br />a,'9!A & L -OgWrned under the laws of
<br />(Type of Bu ess) (State)
<br />of which he is V i n''t!2 ��
<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 indirect! submitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or
<br />t member or age her of.
<br />AFFIANT'S NAME AFFIANT'S TITL
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this -.1,90 day of a { � , 20 a�
<br />Personally Known X or Produced Identification
<br />Type of identification iKrlOLA) '1
<br />(Affix seal here) ✓ J f , G Cf
<br />o *YAv YVE77EZULUAGA NNOO rARY PUBLICL(eame rriintedlorrty a "j
<br />' Z Notary Public - State of Florida
<br />y• V. Commission # KH 205674
<br />of tti My Comm, Expires Ian 7,2026
<br />Bonded through National Notary Assn.
<br />DECEMBER28,2010
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