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SONNV I52F <br />NON -COLLUSION AFFIDAVIT <br />City of Sunny Isles Beach <br />•' •t 18070 Collins Avenue <br />rLoa`O a Sunny Isles Beach, FL 33160 <br />or suR a Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />STATE OF FLORIDA J <br />COUNTY OF Oade ) <br />The undersigned being first duly sworn as provided by law, deposes, and says: <br />This Affidavit is made with the <br />knowledge and intent that it <br />is to <br />be <br />fled <br />with the City of Sunny Isles Beach City Commission <br />and that it will be <br />relied upon by said County, in <br />any consideration which may <br />give <br />to <br />and <br />any action it may take with respect to this Bid. <br />Isles Beach, Florida is directly interested therein. <br />The undersigned is authorized to make this Affidavit on behalf of, <br />AM , �y � <br />(Name of Corporation, Partnership, Individual, etc.) <br />r vf <br />a, DYE , formed under the laws of <br />(Typ of Business) <br />(State) <br />//n <br />of which he is / re f1 t4e 6 I <br />(Sole Owner, Part <br />ner, President, etc.) <br />Neither the undersigned nor any <br />person, firm, or corporation named in above Paragraph 10.2, nor anyone <br />else <br />to the knowledge of the <br />undersignedI have themselves <br />solicited <br />or employed anyone else <br />to solicit favorable action for this Bid by the <br />City, <br />also that no head of any <br />department or employee therein, or any <br />officer of the City of Sunny <br />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 />AFFIANT'S NAME <br />AFFIANT'S TITLE <br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this 0� day of VP�Q.YYIJCA , 20� <br />Personally Known to� or Produced Identification , <br />Type of identification <br />(Affix seal here) <br />NOTARY PUBLIC (name printed or d) <br />. Notery Publlo Siete of Florida <br />Ally6on Ibanez <br />=0111=1 My COMMI$00n HH 413796 <br />EXpiree 812212027 <br />DECEMBER 28, 2010 <br />