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<br />• CITY OF SUNNY ISLES BEACH
<br />• SECTION: SIX: CONTRACT FORMS
<br />•
<br />• SONNY/S/f
<br /> NON - COLLUSION AFFIDAVIT
<br />•
<br /> -;��'•�• • City of Sunny Isles Beach
<br />• •,. 18070 Collins Avenue
<br /> '. •rio��� Sunny Isles Beach,FL 33160
<br /> 9 o, sus '�o+` Telephone:(305)947-0606 Far(305)949-3113
<br />•
<br /> ® STATE OF FLORIDA
<br /> • )
<br /> COUNTY OF BfOWdfd )
<br /> •
<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 /> ® Keith and Schnars
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> 0
<br /> ® a, corporation ,formed under the laws of Florida
<br /> (Type of Business) (State)
<br /> •
<br /> ® of which he is Vice President
<br /> (Sole Owner,Partner, President,etc.)
<br /> •
<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 /> •
<br /> ® Michael L .Davis Vice President
<br /> AFFIANT'S NAME AFFIANT'SAF� TITLE
<br /> f�,r
<br /> ® TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this,'O day of
<br /> AF/21
<br /> l ,2(704012
<br /> ® Personally Known ✓ or Produced Identification •
<br /> 111 ____
<br /> ® Type of identification
<br /> • (Affix seal here)
<br /> ® �i�•Odo!fui iu�
<br /> N o •RY PUB (name prime. or typed)
<br /> MMl87E MOCK® •• 4 MY COMMISSION tEE142118
<br /> ® EXPIRES Feb nary 13,2016
<br /> Bonded Pau Notary Puh&lhdenders
<br /> •
<br /> REITB and SCFTNARS,P.A.
<br /> Ft4RIDAS Ig IDCALFIRM
<br /> ® RFQ12-04-02 PAGE 63
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