Laserfiche WebLink
NON - COLLUSION AFFIDAVIT <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />y <br />c" V4 Sunny Isles Beach, FL 33160 <br />~`'* of SUO "' Telephone: (305) 947 -0606 Fax: (305) 949 -3113 <br />STATE OF FLORIDA <br />COUNTY OF K s ? <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 />(Name of Corporation, Partnership, Individual, etc) <br />a, f , formed under the laws of <br />(Type of Business) (State) <br />of which he is '? t <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 ember or agent thereof. <br />A IANT' NA E AFFIANT'S TITLE IN <br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this X- day of t\ 2006 <br />Personally Known `- or Produced Identification , <br />Type of identification <br />(Affix seal here) <br />AhiY v. NUPvtmZ `...._.. - <br />Commission # EE 111590 -- <br />h PX Ires July 12 20115 OAR UBLIC (name pd d or typed) <br />°`•+`% t¢e ``' 50" ded T6ni 7cay Fain Ins! aqte wo- 395-7049 <br />DECEMBER 28, 2010 1 of 10 <br />