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yV��r 164E <br /> G.�o NON - COLLUSION AFFIDAVIT <br /> \ `-/: City of Sunny Isles Beach <br /> I ,xo <br /> 18070 Collins Avenue <br /> iroi Ya+' Sunny Isles Beach,FL 33160 <br /> o. .0 Telephone:(305)947-0606 Fax:(305)949-3113 <br /> STATE OF FLORIDA ) <br /> nn ) <br /> COUNTY OFg ) <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. y <br /> f-\CA\On l POrt` hA ('re/\\ ( L-0— <br /> (Name of Corporation.Partnership,Individual,etc.) <br /> a. Tern 0.(i A ,formed under the laws of �1��d,CA. <br /> (Type of Business) U (State) <br /> of which he is PreS=ne(\y\ - <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 /> -ccu t) Ac 7)e� 1)i_ES000 +- CW <br /> AFFIANT'S NAME AFFIANT'S TITLE L <br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this Q3 day of 01\Al ,2002 <br /> Personally Known V" or Produced Identification , <br /> Type of IdentifiWtion ' <br /> (Affix seal here) <br /> NOT• -Y PU'i? a printed or typed) <br /> ROCCO D PAC(ELLO <br /> .7'... •::_ NOTARY PUBLIC <br /> 1 ' STATE OF FLORIDA <br /> " orn <br /> Crll#FF041337 <br /> Expires 7/31/2017 <br /> DECEMBER 28.2010 1 of 10 <br />