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SJNN!l�rr(1 <br /> NON - COLLUSION AFFIDAVIT <br /> VI- it -JI <br /> City of Sunny Isles Beach <br /> 18070 Ccens Avenue <br /> •F 10. , Sunny Isles Bea FL 33160 <br /> r <br /> sun' Telephone:(305)947-0606 Fac(305)949-3113 <br /> STATE OF FLORIDA <br /> J <br /> COUNTY OF Brnwatd <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 /> The- Crolebrafi;vr, & u-rco Znv . <br /> (Name of Corporation,Partnership,Individual,etc.) <br /> •a, KVO h-+ Ser U 1 r.5 ,formed under the laws of firDri� <br /> (Type <br /> l of Business) (State) <br /> of which he is Pr e C 1 Cl env <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,finn 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 fuller, neither the undersigned, nor the person,fine 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 /> • <br /> Pre ;den-f- <br /> 1 S NAME ' AFFIANT'S TITLE <br /> 4 pelt <br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this a3 day of Al N3 c r .2011" <br /> Personally Known orProducedIdentification (...".••--;Type of identification f L 0.L. <br /> (Affix seal here) <br /> ,IEKTORAYALA % i <br /> +°•• • BUIpgSSlOD11 Ff 911313 NO ARY a r B (nam hied or typed) <br /> EXPIRES:October 3,2019 <br /> -'4y47 Bolton B:N)dN0.rrySences <br /> an <br /> m[cEMeEn29,2olo 1 of 7 <br />