|
<br />SECTION 10
<br />
<br />NON-COLLUSION AFFIDAVIT
<br />
<br />STATE OF FLORIDA )
<br />)
<br />COUNTY OF 't\o.. \:) E- )
<br />
<br />The undersigned being first duly sworn as provided by law, deposes, and says:
<br />
<br />10.1. This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny
<br />Isles Beach City Commission and that it will be relied upon by said County, in any consideration which
<br />may give to and any action it may take with respect to this Bid.
<br />
<br />10.2. The undersigned is authorized to make this Affidavit on behalf of,
<br />
<br />
<br />I 1(,0<"'" '
<br />
<br />a, lAI\ N \) ~ '.:.A-0?- \:.....{) M. {'A: to -1
<br />(Type of Business)
<br />
<br />. formed under the laws of ~ '-0 ('.....~ f'l .f>,:'"
<br />(State)
<br />
<br />of which he is
<br />
<br />~..) 0 ,,',.) e- "'5"'S \::)~~e--.-oPe.fV
<br />(Sole Owner, Partner, President, etc.)
<br />
<br />10.3. Neither the undersigned nor any person, firm, or corporation named in above Paragraph 11.2,
<br />nor anyone else to the knowledge of the undersigned, have themselves solicited or employed anyone
<br />else to solicit favorable action for this Bid by the City, also that no head of any department or employee
<br />therein, or any officer of the City of Sunny Isles Beach, Florida is directly interested therein.
<br />
<br />10.4. This Bid is genuine and not collusive or a sham; the person, firm or corporation named above in
<br />Paragraph 11.2 has not colluded, conspired, connived or agreed directly or indirectly with any bidder or
<br />person, firm or corporation, to put in a sham Bid, or that such person, firm or corporation, shall refrain
<br />from bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or
<br />communication or conference with any person, firm or corporation, to fix the prices of said proposal or
<br />proposals of any other bidder; and all statements contained in the proposal or proposals described above
<br />true; and further; neither the undersigned, nor the person, firm or corporation named above in
<br />Paragraph 11.2, has directly or indirectly submitted said proposal or the contents thereof, or
<br />divulged information or data relative thereto, to any association or to any member or agent thereof.
<br />
<br />"--\./\ t-J v c:... v ~'-..1 \. ~() ~-'"S \ !'\j:?-:-~) D-s. -.J.E:-......-v f'S{!_
<br />AFFIANT'S NAM E AFFIANT'S TITLE
<br />
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME thisc212 day of y)()V , 200~t
<br />
<br />Personally Known f\ or Produced Identification
<br />Type of identification
<br />
<br />(Affix seal here)
<br />
<br />vefO lei v J I J an U-f V(/
<br />NOTARY PUBLIC (name printed or typed)
<br />
<br />;-~'PII~ PAOLA C VILLANUEVA
<br />~ MY COMMISSION # 00542526
<br />.,..,~
<br />'f~Off\.",$ EXPIRES: Apr.19,201O
<br />(407) 396-0153 Florida Notary SEllVice,com
<br />
<br />END OF SECTION
<br />
<br />PAGE 70 OF 92
<br />BID No, 07-10-04
<br />
|