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<br /> e yx r
<br /> • •, NON - COLLUSION AFFIDAVIT
<br /> • :I City of Sunny Isles Beach
<br /> e 18070 Collins Avenue
<br /> r o"'oo Sunny Isles Beach,FL 33160
<br /> e o, ,,. Telephone:(305)947-0606 Fax:(305)949-3113
<br /> e
<br /> STATE OF FLORIDA
<br /> e COUNTY OF Broward )
<br /> e
<br /> eThe undersigned being first duly sworn as provided by law,deposes,and says:
<br /> e 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 /> erelied 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 /> e
<br /> e Frank Costoya Architect, P.A.
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> e
<br /> • a Corporation (Architecture),formed under the laws of Florida
<br /> ® (Type of Business) (State)
<br /> • of which he is President/ Owner
<br /> (Sole Owner,Partner,President,etc.)
<br /> e
<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 /> edepartment or employee therein,or any officer of the City of Sunny Isles Beach,Florida is directly interested therein.
<br /> eThi' :i. is genuine nd not collusive or a sham;the person,firm or corporation named above in Paragraph 10.2 has not colluded,conspired,
<br /> •. nives or agre'. directly or indirectly with any proposers or person, firm or corporation, to put in a sham Bid, or that such person, firm or
<br /> e •.rporati.n, shall r frain 1r. Bidding,and has not in any manner,directly or indirectly, sought by agreement or collusion,or communication
<br /> •r confer nbie th cny p= •. firm or rporation,to fix the prices of said Bid or Bids of any other proposers;and all statements contained in
<br /> the Bid o b ; ).o e d further; neither the undersigned, nor the person, firm or corporation named above in Paragraph
<br /> 10.2,ha • f ly[rf/nd• I. - it d aid Bid or the contents thereof,or divulged information or data relative thereto,to any association or
<br /> to an = if . .em�� .i -
<br /> Francisco ostoya, Jr. President/Owner
<br /> AFFIANT'S NAME AFFIANT'S TITLE
<br /> Q
<br /> Q TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 30 day of April 2012
<br /> QPersonally Known X or Produced Identification •
<br /> Q Type of identification
<br /> Q
<br /> (Affix seal here) PUBLIC-STATE NOTARY IC-STATE,OF FLORIDA
<br /> "''' Jay C. Evans
<br /> 9 Commission#Dll795.136 NOTA PUBLIC(name print or typed)
<br /> Q ` Expires: JULY 08,2012
<br /> Q Bonin 1IRU ATLANTIC BONULNG CO.,IXC Kr"-
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<br /> ® DECEMBER 28.2010 1 of 7
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