Laserfiche WebLink
i <br /> SVpINY,„, <br /> t ? J <br /> .�4ti <br /> NON- COLLUSION AFFIDAVIT <br /> tri';, _= _ <br /> { •• Vi City of Sunny Isles Beach <br /> Ii. •� 18070 Collins Avenue <br /> s� '•c o a� 0 5` Sunny Isles Beach,FL 33160 <br /> ''o,sum'r Telephone:(305)947-0606 Fax:(305)949-3113 <br /> STATE OF FLORIDA ) <br /> 1 <br /> COUNTY OF ) <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 onbehalfof, <br /> (CJod(�7E - AW ( e?/fcc ( /` <br /> (Name oof ' 'f Corporation,Partnership,Indual,etc.) <br /> /�'/// <br /> a, � /iI4 l formed under the laws of <br /> (Type of Bus' ess) (State) <br /> { <br /> of which he is 1Gtif4tGzlti„ <br /> 1 (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 102 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 /> AFFIANTS NAME AFFIANT'S TITLE <br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this day of ,200_ . <br /> Personally Known or Produced Identification ,• <br /> Type of identification <br /> (Affix seal here) <br /> NOTARY PUBLIC(name printed or typed) <br /> • <br /> i <br /> 1 <br /> DECEMBER 28.2010 1 of 7 <br />