|
4SVNNy/rrE
<br /> O �^ f
<br /> 1 - zk NON COLLUSION AFFIDAVIT
<br /> City of Sunny Isles Beach
<br /> 18070 Collins Avenue
<br /> `e �'' o 4. Sunny Isles Beach,FL 33160
<br /> o, ‘us 'sTelephone:(305)947-0606 Fax:(305)949-3113
<br /> ISTATE OF FLORIDA
<br /> COUNTY OF Miami-Dade)
<br /> 1 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 /> IThe undersigned is authorized to make this Affidavit on behalf of,
<br /> I CSA Central, Inc.
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> I
<br /> a, Corporation
<br /> (Type of Business) ,formed under the laws of Ohio
<br /> (State)
<br /> of which he is Senior 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 /> I 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 /> I 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 tru'; and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph
<br /> 10.2,has directlyndirectly sub ' ed said Bid or the contents thereof, or divulged information or data relative thereto,to any association or
<br /> I
<br /> to any member r agenirthere•
<br /> /4„.; Senior Vice President
<br /> ' AFFI NTS AFFIANT'S TITLE
<br /> /
<br /> ' TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 16th day of April ,2001 2
<br /> Personally Known X or Produced Identification ,
<br /> IType of identification ,
<br /> (Affix seal here) _ / ,/��k =,
<br /> "C"'�s,; DINA K. RHYMES N -Y PUBLIC(namT-nted or typed-
<br /> +° �: Notary Public -State of Florida /
<br /> .alu My Comm.Expires Aug 16,2014
<br /> P: Commission # OD 986056
<br /> v,r ;,d'.
<br /> Bonded Through National Notary Assn.
<br /> 0
<br /> DECEMBER 28,2010 1 of 7
<br />
|