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*"N I I rrrr
<br />of
<br />NON- COLLUSION AFFIDAVIT
<br />•
<br />City of Sunny Isles Beach
<br />•.,r;_
<br />16076 Co ns Avenue
<br />,oi
<br />sr o ' • r t D• � j
<br />Sunny Isles Beach, FL 33160
<br />oa
<br />a, r o, '
<br />Telephone: (305) 947-0606 Fax: (305) 949 -3113
<br />STATE OF FLORIDA FL)
<br />COUNTY OF Miami -Dade 1
<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 vllf 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 />Southern Underground Industries, Inc.
<br />(Name of Corporation, Partnership, Individual, etc.)
<br />a Corporation , formed under the laws of Florida
<br />(Type of Business) (State)
<br />of which he is Vice President
<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, fimr or corporation named above in Paragraph 10.2 has not colluded, conspired,
<br />connived or agreed directly or indirectly with any proposers or person, fine or corporation, to put in a sham Bid, or that such person, firth 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 parson, fine 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 />AFFI T'S NAME
<br />Juan Barreneche , Vice President
<br />AFFIANT'S TITLE
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this day of y �•Cr r y`.2� 1 , 20�A
<br />Personally Knovm or Produced Identification r Imo;
<br />Type of idenfification -R-Ap,-\
<br />(Affix seal here)
<br />*C110 JONNATHAN J. MUNOZ NOTARY PUBLIC tt�OTAC,`. Ul lit, C (name ed or typed)
<br />STATE OF FLORIDA N =U.3 Comm# EE214792 ,�O Expires 7/8/2016
<br />ea� 30,2010 1 of 10
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