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<br /> • YSONNY rfrFt
<br /> • a. NON - COLLUSION AFFIDAVIT
<br /> • - ' City of Sunny Isles Beach
<br /> 18070 Coffins Avenue
<br /> 4*• �' tv op �� Sunny Isles Beach,FL 33160
<br /> • "'or son''oTelephone:(305)947-0606 Fax(305)949-3113
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<br /> • STATE OF FLORIDA� )
<br /> • COUNTY OF ZAGZ )
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<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 /> • ,BES cwi7 SS, .,,z
<br /> (Nam/e,.coffCCorporation,Partnership,Individual,etc.)•
<br /> /��I
<br /> • a, / `C, f/��1 ,formed under the laws of 44/41
<br /> • (Type of Business) (State)
<br /> �•�
<br /> • of which he is P �"04W/`//
<br /> • (Sole Owner,Partner,President,etc.).
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<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 /> •• "?,46
<br /> • A IANTL5 NAME AFFIANT'S TITLE
<br /> • , ll/At Eue
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<br /> • TAKEN,SWORN AN✓/D SUBSCRIBED TO BEFORE ME this 214V-day of at ,200
<br /> • Personally Known or Produced Identification
<br /> • Type of identification
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<br /> • (Affix seal here) , Y/595Ie:a /)oya s
<br /> • NOTARY PUBLIC(name printed or typed)
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<br /> • NOTARY PUBLIC-STATE OF FLORIDA
<br /> 9' ¢•. Jessica Morales
<br /> ®
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<br /> • DECEMBER 28.2010 1 of 7
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