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<br />NON-COLLUSIVE AFFIDA vir <br /> <br />State of rL-- <br />County of n\A",,-I- DA "Df- <br /> <br />I ~6N6- f. r:IZA~A: <br />and says that: <br /> <br />(1) He/she is the (4~), Partner, Officer, Representative or Agent) of the Bidder that has <br />submitted the attached Bia~ <br /> <br />being first duly sworn, deposes <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 oQw:ents, representatives, owners, employees or parties in interest, including this <br />A ffiantf <br /> <br />(\ - -(- <br />112.4r6 f ffLAG.L\ <br />SIGNA TURE OF AFFIANT (Printed or Typed Legal Name of Affiant) <br /> <br />State of f L-- <br /> <br />County of M\Ar\\- tV\~6 <br /> <br />Sworn to and subscribed before me this Url--\ day of <br /> <br />n~'1 <br /> <br />,2010 by <br /> <br />I IZ-tNG ~. fYlA6../t <br /> <br />~ ---~ <br />~ <br />Notary's Name Printe <br /> <br /> <br />c5'----- - <br />(Sfamped or Typed <br />_...-/ <br /> <br />Notary Seal: <br /> <br />Personally Known: <br /> <br />or Produced Identification <br /> <br />'A <br /> <br />~~~~~'v:~~~: ERIC SANTA-CRUZ <br />~\~.:;~ MY COMMISSION # 00769865 <br />'~i-(;Ff\.~' EXPIRES March 17,2012 <br />'11111'\ <br />(407) 398-0153 FloridaNotaryService.com <br /> <br />Identification Produced <br /> <br />'V.v. <br />