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y0NNY r\rrF <br /> S, a- ' -fir T <br /> NON - COLLUSION AFFIDAVIT <br /> ` � City of Sunny Isles Beach <br /> ' / 18070 Collins Avenue <br /> se <br /> . rro^` o+` Sunny Isles Beach,FL 33160 <br /> o, sus '. Telephone:(305)947-0606 Fax:(305)949-3113 <br /> STATE OF FLORIDA ) <br /> COUNTY OF Broward ) <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 /> ACAI Associates. Inc <br /> (Name of Corporation, Partnership, Individual,etc.) <br /> a, Corporation ,formed under the laws of Florida <br /> (Type of Business) (State) <br /> of which he is 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 /> 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 /> Mr� <br /> y L_ President <br /> AFFIANT'S AME AFFIANT'S TITLE <br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 1St day of May ,2012 <br /> Personally Known ✓ or Produced Identification , <br /> Type of identification <br /> (Affix seal here) <br /> Sandra Smerkers / 4[/ IL-- <br /> Notary Putile <br /> L--Ne1M'PutSC State el norkli NOTARY PUBLIC(na e - ted r ed) <br /> :a' Sandra Smerken <br /> a R My lm 08/1 i/2 EE121726 <br /> ar Exp08/19!2015 <br /> City of Sunny Isles Beach I Request for Proposal No. 12-04-02 77 <br />