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The Celebration Source Inc.
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(16-09-03) Event Rides
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The Celebration Source Inc.
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Last modified
10/17/2016 9:48:15 AM
Creation date
10/17/2016 9:48:12 AM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Event Rides Rental
Bid No. (xx-xx-xx)
16-09-03
Project Type (Bid, RFP, RFQ)
Bid
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ANN♦IJ <br /> Oi S 'b""\r\1 <br /> '_ NON - COLLUSION AFFIDAVIT <br /> ^I` I <br /> City of Sunny Isles Beach <br /> " 18070 Cams Avenue <br /> b <br /> se )10� a+' Sunny Isles Beach,FL 33160 <br /> a. sun'� Telephone:(305)907-0606 Fax(305)90?3113 <br /> STATE OF FLORIDA ) <br /> COUNTY OF BMurarrt) <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 /> lhr0 Cekbritro i Source.. --fie.--. <br /> (Name of Corporation,Partnership,Individual,etc.) <br /> Evevrt- Honi d <br /> a ,eo`1/i(�S ,formed under the laws ofa <br /> (Type of Business) (State) <br /> of which he is V rct Pre,jAeht" <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,fire 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 fox 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. ..ent thereof. <br /> 111110 V,cc- Pres1 e1e pit <br /> AFFIANTS NAME W-- . AFFIANTS TITLE <br /> / �/ n ae/6 <br /> W) <br /> TAKEN.S RN AND SUBSCRIBED TO BEFORE ME this.1`'l day of (2G T 19 v' ..260—.-- <br /> Personally <br /> 26(I!Personally Known or Produced Identification <br /> Type of identification F L C <br /> (Affix seal here) �� <br /> N• if Y R.:LIC(name printed or typed) <br /> AA."'a JEXTOR AYALA <br /> iLWIA MY COMMISSION t FF 911313 <br /> * * <br /> EXPIRES:October 3,2019 <br /> °j+r of soreld1tn 3WpdNdaySNrffi <br /> rrcai ata 2e.2010 1 of 7 <br />
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