BetaJones Group, Inc., The Bid Document (38)

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STATE OF FLORIDA NON -COLLUS I ON AFFIDAVIT City of Sunny Isle s Beach 18070 Collins Avenue Sunny Isles Beach , FL 33160 Telephone: (305) 947-0606 Fax : (305) 949-3113 COUNTY OF MIAMI-D ADE ) The undersign ed being first duly sworn as provided by law , deposes, and says : This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach Ci ty Commission and that it will be relied upon by said County, in any consideration which may give to and any action it may take with respect to this Bid . The undersigned is authorized to make this Affidavit on behalf of, The BetaJones Group , Inc (Name of Corporation , Partnership , Individual, etc.) S Corporation Florida a ,----:=----:-:::--.,....----,------' formed under the laws of ___ -:-=-,-,--:- (Type of Business) (State) of which he is __ P_r_i n_c_i_p_a_I_---:-=-:--:::----:=-----=--=-:---:----:- (Sole Owner, Partner, President, etc.) Neither the undersigned nor any person , firm , or corporation named in above Paragraph 1 0.2, nor anyone else to the knowledge of the undersigned , have themselves solicited or employed anyone else to solicit fa vorable action for this Bid by the City , also that no head of any department or employee therein , or any officer of the City of Sunny Isles Beach , Florida is directly interested there in . This Bid is genuine and not collusive or a sham ; the person , firm or corpora tion named above in Paragraph 10.2 has not colluded , conspired , connived or agreed directly or indirectly with any proposers or person , firm or corpora tion, to put in a sham Bid , or that such person , firm or corporation, shall refrain from Bidding , and has not in any manner, directly or indire ctly , sought by agreement or collusion , or communication 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 the Bid or Bids described above true ; and further; neither the undersigned , nor the person , firm or corporation named above in Paragraph 10.2 , has directly or indirectly submitted said Bid or the contents thereof, or divulged information or data relat ive thereto , to any association or to any member or agent thereof. Luis A . Betalleluz Principal AFFIANT'S NAME AFFIANT'S TITLE TAKEN , SWORN AND SUBSCRIBED TO BEFORE ME th is 14 th day of __ J_u_ly ______ , 20 26 Personally Known __ X __ or Produced Identification ___ _ Type of identifica tion--------------- (Affix seal here) DECEMBER 28 , 2010 MICHELlE LOPEZ Notary Public State of Florida Comm• HH33434 7 Expires 1/15/2027 Michelle C. Lopez ~ NOTARY PUBLIC (name printed or typed) 78 The BetaJones Group/RFQ#26-07-01