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<br />NON-COLLUSIVE AFFIDA VIT
<br />
<br />State of fL )
<br />
<br />County of ~\At'\' - DA:9€ )
<br />
<br />lZ-OLAN DO S\l..\JA. being first duly sworn, deposes
<br />and says that:
<br />
<br />(1) He/she is the ~0artner, Officer, Representative or Agent) of the Bidder that has
<br />submitted the attached~
<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 coIlusive 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 coIlusion, 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 coIlusion, 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 />Af~~9k7 /), ,)
<br />I j/ l l
<br />SIGNA TURE OF AFFIANT
<br />
<br />---l
<br />
<br />F-oL.A.N~O SIt.:"A
<br />(Printed or Typed Legal Name of Affiant)
<br />
<br />State of fL.-County of t{\Af'\ \- PA,pe
<br />
<br />Sworn to and subscribed before me this '2.61'-\ day of
<br />
<br />~A'{
<br />
<br />,2010 by
<br />
<br />(2oL..ArJ'Po SlL'\JA.
<br />
<br />c:~
<br />
<br />Notary's Name Pri ped or Typed
<br />
<br />_,__0
<br />
<br />Notary Seal:
<br />
<br />Personally Known:
<br />
<br />or Produced Identification
<br />
<br />D. L.. .
<br />
<br />:~~I!X~~ ERIC SANTA-CRUZ
<br />~i&.:~~ MY COMMISSION # 00769865
<br />>",,'fr,'i~ EXPIRES March 17,2012
<br />(407) 396-0153 FloridaNoteryServlce.com
<br />
<br />Identification Produced
<br />
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