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<br />NON-COLLUSIVE AFFIDA VIT
<br />
<br />State of ~\Df'i do. )
<br />
<br />County of H;o.mi - 't:XJ.d)12..
<br />
<br />-:Ii \\ ~1 i n~e.t+e:r CJn j () -" Oa,
<br />and says that:
<br />
<br />being first duly sworn, deposes
<br />
<br />(1) He/~ 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, tirm, 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 />J711 l A J;~e.yte, Chif\-'1 <.~
<br />IANT (Printed or Type egal Name of Affiant)
<br />
<br />State of l%~d.4 County of !/;;1MI' 0f./-CIF
<br />
<br />
<br />Sworn to and subscribed before me this ,2~ rJ. day of
<br />
<br />j; 1/ W t!h/~- t-Io(.l..
<br />
<br />;/~
<br />
<br />,2010 by
<br />
<br />4-,,/,, r/ ;},re€v - ~ 1flJ-
<br />
<br />Notary's Name Printed, Stampe or Typed /
<br />
<br />/
<br />
<br />Personally Known:
<br />
<br />or Produced Identification
<br />
<br />~"\\\"'III',,,,1.
<br />~"~~Q~ M. ~-t9.'11111,.
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<br />
<br />Identification Produced
<br />
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