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® r. VµµY.1st.7Ff. . <br /> o� NON - COLLUSION AFFIDAVIT <br /> ® ` City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> /' .. <br /> - ' af•,pio�� Sunny Isles Beach.FL 33160 <br /> Telephone:(305)947-0606 Fax:(305)949-3113 <br /> 0 <br /> STATE OF FLORIDA <br /> ® COUNTY OF Palm Beach ) <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 /> ® Kimley-Hom and Associates, Inc. <br /> (Name of Corporation, Partnership,Individual,etc.) <br /> 0 an Engineering Company ,formed under the laws of North Carolina <br /> ® (Type of Business) (State) <br /> O of which he is Senior Vice President/Principal Associate <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 /> 0 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 /> O Jerry Ingram,P.E. lY f,1 Senior Vice President/Principal Associate <br /> 0 AFFIANT'S NAME Y AFFIANT'S TITLE <br /> • 2012 <br /> ® TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 30th day of April ,x vc. <br /> Personally Known X or Produced Identification <br /> Type of identification <br /> ® (Affix seal here) - / JCCA`/O <br /> ® <br /> NOTARY PUBLIC(name printed or typed) <br /> 41;,04/4-4TAMMY L SCARLOTT <br /> MY COMMISSION#EE161709 <br /> EXPIRES January 19.2016 <br /> ® (4e1)mold FlorldliNeteryeaviatCan <br /> 0 <br /> ® DECEMBER 28.2010 1 of 7 <br />