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s?H=rrr <br /> ....�,• itt <br /> NON - COLLUSION AFFIDAVIT <br /> t <br /> '�•-•, 12 j•• City of Sunny Isles Beach <br /> 15070 Collins Avenue <br /> MO s Sunny Isles Beach,FL 33160 <br /> m .,, Telephone:(305)947-0606 Fa.:(305)949-3113 <br /> STATE OF FLORIDA ) <br /> n ) <br /> COUNTY OF Rcar.62.1) ) <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 he <br /> retied upon by said County,in any consideration which may give to and any action it may take with respect to this Bid. <br /> The undemigned is authorized to make this Affidavit on behalf o�C\CT\ 1_-Pt\ iz klgre e ncnkf l (-0...__.( of Corporation.Partnership.Individual, c.) <br /> A <br /> a- re 4 ¶ AC,,.5.6,,.5.6 .formed under me laws of t`C \6.CA. <br /> ype of Business) (State) <br /> of which he is tPre5zprCct <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, 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 /> ' CCUt a \00•)C.a Qc-ES0(PI 4- Lip <br /> AFFIANT'S NAME AFFIANT'S TITLE <br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 23 day of r`R'� .20QI0 <br /> Personally'Known or Produced Identification • <br /> Type of identification <br /> (Affix seal here) <br /> KYS..PU41alta a printed or typed) <br /> _ ROCCO 0 PACIELLO <br /> .7' NOTARY PUBLIC <br /> STATE OF FLORIDA <br /> .-at' Commit FF041337 <br /> Expires 7/312017 <br /> DEC.Elarq 25.2010 1 of 10 <br /> p i tl <br /> 4J 3 <br />