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being first did), sworn, deposes <br />and saes that: <br />(1 l ic!shc is the (Owncr. Parulcr, Ofticcr, Representati. e or A,1(mi) of the Bidder that has <br />submitted the attached Bid: <br />(Z) Heishe is fully informed respecting the preparation and contents of the attached Bid and <br />of all pertinent circumstances respecting such Bic?.; <br />(3) Such Bid is genuine and is not a collusive or sham Bid; <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 <br />advantage against the City of Sunny Isles Beach, or any person interested in the proposed Work; <br />(S) 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 />i <br />SIGNATURE OF AFFIANT (Printed or Typed Legal Name of Affiant) <br />State of County of <br />Sworn to and subscribed before me this day of , 2002 by <br />Notary's Name Printed, Stamped or Typed <br />Personally Knowm: or Produced Identification <br />Identification Produced <br />Pag, 10 of 10 <br />Muhtnpal Contract Services F.fq <br />Notary Seal: <br />