Laserfiche WebLink
SUNN! ISff <br />f1 <br />0 ff <br />(Affix seal here) <br />NON -COLLUSION AFFIDAVIT <br />ABETH PAGE <br />lic . State of Florida <br />City of Sunny Isles Beach <br />sion( &424mar 2904025ExP <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br />Telephone: (305) 947-0606 Fax: (305) 94941113 <br />STATE OF FLORIDA <br />t ,n ) <br />COUNTY OF' iii QIIIv1�-NA <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 />Wtkc/Vi gin�ennq,�nc <br />(Name of Corporation, Partnership, Individual, etc.) <br />a, NYPOY I ` Y1 . formed under the laws of 1 al d (1, <br />(Type of Business) (State) <br />of which he is I y `t u 1 <br />(Sole Owner, Partner, President, etc.) <br />Neither the undersigned nor any person, fine, 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 fur 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 />AFFIANTS NAME AFFIANT's TITLE <br />TAKEN, SWORN AND SU/BSCRIBED TO BEFORE ME this (�0 I, 1day ofU. ^IU , 20 —Z --b <br />Personally Known v/ or Produced Identification <br />Type of identification <br />f1 <br />(Affix seal here) <br />ABETH PAGE <br />lic . State of Florida <br />902 <br />sion( &424mar 2904025ExP <br />ASST. National !lotarl <br />DECEMBER2e,2010 <br />2 3 055 o 2 <br />NOTARY ELIC (name printed or typed) <br />3-7 <br />