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<br />NON -COLLUSION AFFIDAVIT
<br />V _
<br />City of Sunny Isles Beach
<br />•', "':�_ " 18070 Collins Avenue
<br />�. 'Ds • p lOP`O S° Sunny Isles Beach, FL 33160
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<br />or s�N'` Telephone: (305) 947-0606 Fax: (305) 949-3113
<br />r, STATE OF FLORIDA )
<br />COUNTY OFIVI*aMt
<br />51 f_
<br />The undersigned being first duly sworn as provided by law, deposes, and says:
<br />y..� 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 />h')
<br />Y (Name of Corporation, Partnership, Individual, etc.)
<br />a, K' b f4T10'�% formed under the laws of L
<br />(Type of Business) (State)
<br />of which he is
<br />(Sole Owner, Partner, President, etc.)
<br />j
<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 />�f
<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 />�,►5 to any member or agent thereof.
<br />AFFIARFFNAME AFFIANT'S TITLE
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this ZXik day of lV OVGM4C 202.3
<br />! Personally Known or Produced Identification
<br />Type of identification Fl- Drt J��1 Lr cG,�lfG
<br />(Affix seal here)
<br />J• O ARY P BLIC (name printed or typed)
<br />;f -
<br />Il
<br />k
<br />v °Ge JOSE JAIMES
<br />e � Notary Public, State of Florida
<br />I; " Commission# HH 323046
<br />- , My comm. expires Oct. 17, 2026
<br />DECEMBER 2B, 2010 -
<br />299
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