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0 NON - COLLUSIVE AFFIDAVIT <br />State of U <br />)ss <br />County of�42 <br />!S being first duly sworn, <br />deposes and says that: <br />(1) He /she is the Owner, Partner, Officer, Representative or Agent of the Bidder that <br />has submitted the attached Bid; <br />(2) He /she is fully informed respecting the preparation and contents of the attached <br />Bid and of all pertinent circumstances respecting such Bid; <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, <br />representatives, employees or parties in interest, including this affiant, have in any <br />way colluded, conspired, connived or agreed, directly or indirectly, with any other <br />• Bidder, firm, or person to submit a collusive or sham Bid in connection with the <br />Work for which the attached Bid has been submitted; or to refrain from bidding in <br />connection with such Work; or have in any manner, directly or indirectly, sought <br />by agreement or collusion, or communication, or conference with any Bidder, <br />firm, or person to fix the price or prices in the attached Bid or of any other Bidder, <br />or to fix any overhead, profit, or cost elements of the Bid price or the Bid price of <br />any other Bidder, or to secure through any collusion, conspiracy, connivance, or <br />unlawful agreement any advantage against the City of Sunny Isles Beach, or any <br />person interested in the proposed Work; <br />(5) The price or prices quoted in the attached Bid are fair and proper and are not <br />tainted by any collusion, conspiracy, connivance, or unlawful agreement on the <br />part of the Bidder or any other of its agents, representatives, owners, employees or <br />parties in interest, including this affiant. <br />Sworn to and subscribed before me this <br />-J ,,Q".EES -t—/:Z> e f E <,— who <br />Notary Seal: N```( TMGK Watkowski <br />MY Commission DD178M <br />des Y24,2007 <br />1 Request For Proposal Form <br />_ day of D 2001, by <br />is personally known tome or has provided <br />as identification. <br />Notary <br />