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<br />Attachment D2 <br /> <br />MIAMI-DADE COUNTY DEBARMENT DISCLOSURE AFFIDAVIT <br />(Ordinance 93-129, Section 1) <br /> <br />I, being duly first s om, upon oath deposes and says that the bidder of this <br />contract or his age t , officers, principals, stockholders, subcontractors or their <br />affiliates are not de a ed by iam' Dade County. <br /> <br />By: <br /> <br /> <br />11-'2-0-- 0 J <br />(Date) <br /> <br />SUBSCRIBED AND SWORN TO (or affirmed) before me this '2~O~'t-day of 1\,)0\ U)I)"jWlJ <br />200-1.. by (y\ \C\'~O-(2._ ~"~ 'i~\-() \ \'\ ~'AI'Y\\{))'\.) . He/She <br /> <br />is personally known to me or has presented <br /> <br />.....~...... ......--.-- <br /> <br />(Type of Identification) <br /> <br />as identification. <br /> <br />.~ti~~l-~ ~1;..,~ <br /> <br />" <br /> <br />(Si(mature of Notary) <br />,01" '0. ~ane-'Alberta Hines <br />}' ,/1"1- <br />: .~"., ~ My Commission 000248"6 <br />~; ~,,..-.II Expires May 13. 2005 <br /> <br />-D~b () 2-4~ LIt.. <br />(Serial Number) <br /> <br />. (Print or Stamp of Notary) <br /> <br />S--13'-oC- <br />(Expiration Date) <br /> <br />Notary Public - Stamp State of <br /> <br />n~-A: <br />(State) <br /> <br />Notary Seal <br /> <br />5/01 <br />