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<br />NON-COLLUSIVE AFFIDAVIT
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<br />County of
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<br />FLo12.l01r )
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<br />State of
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<br />Samuel M. Rosania
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<br />being first duly sworn,
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<br />deposes and says that:
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<br />(1) He/she is the (Owner, Partner, Officer, Representative or Agent) of
<br />the Bidder that has submitted the attached Bid;
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<br />(2) He/she is fully informed respecting the preparation and contents of
<br />the attached Bid and of all pertinent circumstances respecting such Bid;
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<br />(3) Such Bid is genuine and is not a collusive or sham Bid;
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<br />(4) Neither the said bidder nor any of its officers, partners, owners,
<br />agents, representatives, employees or parties in interest, including this
<br />affiant, have in any way colluded, conspired, connived or agreed, directly
<br />or indirectly, with any other Bidder, firm, or person to submit a
<br />collusive or sham Bid in connection with the Work for which the attached
<br />Bid has been submitted; or to refrain from bidding in connection with such
<br />Work; or have in any manner, directly or indirectly, sought by agreement
<br />or collusion, or communication, or conference with any Bidder, firm, or
<br />person to fix the price or prices in the attached Bid or of any other
<br />Bidder, or to fix any overhead, profit, or cost elements of the Bid price
<br />or the Bid price of any other Bidder, or to secure through any collusion,
<br />conspiracy , connivance, or unlawful agreement any advantage against the
<br />City of Sunny Isles Beach, Florida, or any person interested in the
<br />proposed Work;
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<br />(5) The price or prices quoted in the attached Bid are fair and proper
<br />and are not tainted by any collusion, conspiracy, connivance, or unlawful
<br />agreement on the part of the Bidder or any other of its agents,
<br />representatives, owners, employees or parties in interest, including this
<br />Affiant.
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<br />_A-
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<br />Samuel M. Rosania
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<br />SIGNATURE OF AFFIANT (Printed or Tl~ed Legal Name
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<br />State of A'1'i"/~county of ////J.tI~/':I"'Y ~
<br />Sworn to and subscribed before me
<br />{)~h6p r , 2007 by
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<br />fJ.;2t:: d ?//' :1JJ"""~
<br />a~c:.-..,,-- ~ '.-J-V ~t/l...::1I
<br />k.lV" 'c:.. /.^- A. ~r e vz.J -.: ,"--/-
<br />Notary's Name Printed, Stamped or Typed
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<br />of Affiant)
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<br />this
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<br />d3 r#~
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<br />day
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<br />of
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<br />Notary Seal:
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<br />Personally Known: ~
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<br />Identification
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<br />or Produced Identification
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<br />Produced ~ rJ u 11 ~ / ~ /c./'1 C/.:.v~_
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<br />I' '~"';.'" .,.....,....................
<br />: PATRICIA A. STEWART~
<br />: \\"U"'II""
<br />: ..'\~Y p&~~ CommI DD03IIIIO
<br />: !~rnVo\ e.,. tMlJOQl
<br />i \~~>> IoncIId IlN (IOO)UM14
<br />. IIIHnlV Florida
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