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SVµr4Y is(E <br />NON -COLLUSION AFF'IUAVIT <br />City of Sunny Isles Beach <br />• 15070 Collins Avenue <br />Ft 91 Sunny Isles Reach, FL 33150 <br />�'tr o, su" '�v Telephone: (305) 947-0605 Fax: (305) 949.3113 <br />STATE OF FLORIDA I <br />COUNTY OF 13120cam) <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 />B 7.4y <br />(Name of Corporation, Partne ip,`Individual, etc.) <br />a. 711 , formed under the laws of <br />(Type of Business) (State) <br />of which he is aCNd-a-f - <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 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 SUBSCRIBED TO BEFORE ME this 7A day of J-Iu C`Q , 20 2 q <br />Personally Known or Produced Identification /- <br />Type of identification <br />(Affix seal here) <br />JESUS ADRIEL LOPEZ <br />A.No Public, State of Florida <br />Commissions GG 976764 <br />IAy comm. expires April 7, 2024 <br />DECEMBER28,2010 <br />194 <br />58 Green Facility, Inc. Bid # 24-01-01 <br />