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<br />NON-COLLUSIVE AFFIDA VIT <br /> <br />State of ~) <br /> <br />County of tv{ ic\A;0 - nxk ) <br /> <br />Nv\CV'O tldVIV10 -l'It;\\a.r <br />and says that: <br /> <br />being first duly sworn, deposes <br /> <br />(1) He/she is the (Owner, Partner, Officer, Representative or Agent) of the Bidder that has <br />submitted the attached Bid; <br /> <br />(2) He/she is fully informed respecting the preparation and contents of the attached Bid and <br />of all pertinent circumstances respecting such Bid; <br /> <br />(3) Such Bid is genuine and is not a collusive or sham Bid; <br /> <br />(4) Neither the said bidder nor any of its officers, partners, owners, agents, representatives, <br />employees or parties in interest, including this affiant, have in any way colluded, conspired, <br />connived or agreed, directly 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 Bid has been <br />submitted; or to refrain from bidding in connection with such Work; or have in any manner, <br />directly or indirectly, sought by agreement or collusion, or communication, or conference with <br />any Bidder, firm, or person to fix the price or prices in the attached Bid or of any other Bidder, or <br />to fix any overhead, profit, or cost elements of the Bid price or the Bid price of any other Bidder, <br />or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage <br />against the City of Sunny Isles Beach, Florida, or any person interested in the proposed Work; <br /> <br />(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by <br />any collusion, conspiracy, connivance, or unlawful agreement on the part of the Bidder or any <br />other of its agents, representatives, owners, employees or parties in interest, including this <br />Affiant. <br /> <br />~ - <br />/eX(' ~ <br />SIGNATURE OF AFFIANT <br /> <br />.M\,\'nv\O thVlVlo-\-t, \\y-- <br />(Printed or Typed Legal Name of Affiant) <br /> <br />State of 1= L <br /> <br />County of MICVV\\- D:Ad.e. <br /> <br />dayof M~j <br /> <br />,2010 by <br /> <br />Sworn to and subscribed before me this I 0 <br /> <br />~ ~VlvU) -KI\~ <br /> <br />~ <br /> <br />Notary' Name Printed, Stamped or Typed <br /> <br />Notary Seal: <br /> <br /> <br />S. BUZZANELL <br />MY COMMISSION. DO 976361 <br />EXPIRES: April 26, 2014 <br />Bonded Thru Notary Public UnderwritelS <br /> <br />Personally Known: <br /> <br />or Produced Identification ---.L <br /> <br />Identification Produced ~bO - 001- t? (,- s'1 b- 0 <br /> <br />F-L.O.L. <br />