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FAQ SAONY's`6��m <br />NON -COLLUSION AFFIDAVIT <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny isles Beach, FL 33180 <br />c,r� ov suN "'`� Telephone: (305) 94T-0606 Fax; (305) 949-3113 <br />STATE OF FLORIDA j <br />COUNTY OFUWL-WI-e <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 />ArPtS 1p�.ft= TGAVIIsanvr Immo► : kerry��,rtpc) <br />(Mama o: Corporation, Partnership, Individual, etc:) <br />a, formed under the laws of V Ivy% da <br />(Type of Business) (State) <br />of which he is W Q 0 W ne, Y' <br />(Sole Owner, Partner, President, etc.) <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 department or <br />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 has not colluded, conspired, connived or agreed <br />directly or indirectly with any proposers or person, firm or corporation, to put In a sham Bid, or that such person, firm or corporation, shall <br />refrain 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 further; neither the undersigned, nor the person, firm or corporation named above has directly or indirectly <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 />A ANT'S NAME AFFIANT'S TITLE <br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this � day of WSW .2023 <br />Personally Known or Produced Identification 11Lf _; <br />Type of ldentification oot )F-Vc Ul ct l &e' <br />(Affix seal here) <br />Notary Pubbo State of Florida <br />Adrtana Rt)o <br />My Cornmhwon HH 008456 <br />�ia��d�' Expire$05131= <br />0513112024 <br />966(AnCA Riau <br />NOTARY PUBLIC (name printed or typed) <br />lPm&kge u.rfaranS r --{-owint + recow ry Fn(- . <br />RFQ R' 2 3-05-0) 1 of 8 <br />