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<br /> I CITY OFSUNNY ISLES BEACH
<br /> SEQT•1ONSIXi CONTRACT FORMS y ��
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<br /> • SUNNY is,,
<br /> • _.., ,:77?,•S.
<br /> • 0 to
<br /> 0 NON - COLLUSION AFFIDAVIT
<br /> • • City of Sunny Isles Beach
<br /> . Q'• 18070 Collins Avenue
<br /> ••'.1$'F 1o• a+` Sunny Isles Beach,FL 33160
<br /> ® of fun'� Telephone:(305)947-0606 Fax:(305)949-3113
<br /> s
<br /> 0 STATE OF FLORIDA )
<br /> ® )
<br /> COUNTY OF BfOWdrd )
<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 fled 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 /> •
<br /> • Keith and Schnars
<br /> (Name of Corporation, Partnership, Individual,etc.)
<br /> •
<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 /> • 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 /> 0 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'S TITLE 1/� ��/�{{2
<br /> •
<br /> • TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this day of J gI I .26024
<br /> • Personally Known s// or Produced Identification • i
<br /> • Type of identification
<br /> •
<br /> (Affix seal here)• SI
<br /> N• 'RY PUB (name prince• • typed)
<br /> y%r. w MARLENE PINNOCK
<br /> ,• MY COMMISSION l EE 142116
<br /> • *,' _ EXPIRES:February 13,2016
<br /> *TS/ BatlS Thu Noisy REBc Uedeal0n
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<br /> :
<br /> _ 4 v, KEITH and SCHNARS,P.A.
<br /> • RFQ12-04-02 PAGE 39 rID1UDA55 WCAL Flats
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