|
OE ti. ^!_<F
<br /> .,„...„..../. .......„:7,
<br /> ;, NON - COLLUSION AFFIDAVIT
<br /> :\�. City of Sunny Isles Beach
<br /> .j,-/ 18070 Coffins Avenue
<br /> ~r
<br /> r°'• ..�o', Sunny Isles Beach,FL 33160
<br /> e'' ,
<br /> o w•' Telephone:(305)9470606 Fax(305)9143113
<br /> STATE OF FLORIDA )
<br /> COUNTY OF Broward ) )
<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 sad 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 /> Jacey Investments, L.L.C. d/b/a Elite Tent Company
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> a, Limited Liability Corporation ,formed under the laws of Florida
<br /> (Type of Business) (State)
<br /> of which he is President
<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 soficit 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 colkded,conspired,
<br /> connived or agreed directly or indirectly with any proposes 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 i .irectly submitted .id Bid or the contents thereof, or divulged information or data relative thereto,to any association or
<br /> to any member or ag. thereof.
<br /> i
<br /> Jason R. Wells I 410—President
<br /> AFFIANTS NAM •
<br /> - AFFIANTS TITLE
<br /> TAKEN,SWORN•• SUBSCRIBED TO BEFORE ME this 231dlay of August ,200 16
<br /> Personally Known V or Produced Identification ,•
<br /> Type of identification
<br /> here) LETICIA ROMAN 1 DTIC IG VU(Y1G(1
<br /> MY COMMISSION 0 FF244407
<br /> •• '! •.•• EXPIRES June 25,7010 NOTARY PUBLIC(name printed or typed)
<br /> •
<br /> OM 3140153 nonsaflU,rSamos.cors
<br /> DECEMBER 28,2010 1 of 7
<br />
|