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ICivil/Environmental Engineering 16-5
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<br /> =- NON - COLLUSION AFFIDAVIT
<br /> V. 1 _ I
<br /> � ' -; • City of Sunny Isles Beach
<br /> •- 18070 Collins Avenue
<br /> •rio•`�o.` Sunny Isles Beach,FL 33160
<br /> '•o. 10 Telephone:(305)947-0606 Fax:(305)949-3113
<br /> STATE OF FLORIDA I
<br /> 1 COUNTY OF Miami-Dade) )
<br /> The undersigned being first duly s om as provided by law,deposes.and says:
<br /> 1 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 /> illAtkins North America, Inc.
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> I
<br /> a, corporation ,formed under the laws of Florida
<br /> (Type of Business) (State)
<br /> I of which he is Senior Vice President
<br /> (Sole Owner,Partner,President,etc.)
<br /> I 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 /> I to any .ember or agent thereof.
<br /> aSenior Vice President
<br /> !ANTS NAME AFFIANT'S TITLE
<br /> avid Carter, CCM
<br /> I TAKEN,SWORN AND. SUBSCRIBEDSTO BEFORE ME this l8th day of April .2012
<br /> Personally Known t/ or Produced Identification ,
<br /> Type of identification
<br /> I
<br /> (Affix seal here) n
<br /> n 1, _ _ _ _ _ NOT PUBLIC(name prince or typed)
<br /> II Julia Forgione
<br /> 1 �,.•�,.',�.,, JULIA FORBIONE f 9
<br /> 1 A 1°`4Notary Public-State of Florida I
<br /> 1 • •p My Comm. Expires Nov 4,2015 f
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<br /> ( P: Commission I EE 137344
<br /> '^,,,,, Bonded Through National Notary Assn. 0
<br /> iiWorkownwripwrIk
<br /> I
<br /> OECEveE42e.2010 1 of 7
<br /> 0006.027944.0512 Atkins I City of Sunny Isles Beach, RFQ No. 12-04-02
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