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1V 1yNT)4, <br /> NON - COLLUSION AFFIDAVIT <br /> V - IZ <br /> City of Sunny Isles Beach <br /> .\ <br /> 18070 Cis Aue <br /> • ..7-C-00 <br /> 1 o•`.' Sunny 151es Beall,FL 33160 <br /> o. rum' Telephone:(305)947-0606 Far.(305)949-3113 <br /> STATE OF FLORIDA <br /> COUNTY OF Berard <br /> The undersigned being fust duly sworn as provided by law,deposes,and says: <br /> This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it wit be <br /> relied upon by said County.in any consideration which may give to and any action it may take with respect to this Bid. <br /> The undersigned is authorized to make this Affidavit on behalf of, <br /> The (4f brzt SL 2L/ mac. <br /> (Name of Corporation.Partnership,Individual.etc.) <br /> r <br /> a. bveyJervic25 .formed under the laws of non Q <br /> (Type of Business) (State) <br /> of which he is Vie- kir e Si Y1`r <br /> (Sole Owner,Partner,President.etc.) <br /> Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10.2. nor anyone else to the knowledge of erre <br /> undersigned,have themselves solicited or employed anyone else to solicit favorable action for this Bid by the City,also that no head of any <br /> department or employee therein,or any officer of the City of Sunny Isles Beach,Florida is directly interested therein. <br /> This Bid is genuine and not collusive or a sham:the person,firm or corporation named above in Paragraph 10.2 has not colluded.conspired. <br /> connived or agreed directly or indirectly with any proposers or person,firm or corporation,to put in a sham Bid,or that such person,firm or <br /> corporation.shall refrain from Bidding,and has not in any manner,direWy or indirectly,sought by agreement or collusion,or communication <br /> or conference with any person,firm or corporation.to fix the prices of said Bid or Bids of any other proposers;and all statements contained in <br /> the Bid or Bids described above true: and further•neither the undersigned,nor the person,firm or corporation named above in Paragraph <br /> 10.2.has directly or indirectly submitted said Bid or the contents thereof.or divulged information or data relative thereto,to any association or <br /> to any member ent thereof. <br /> • <br /> � Lrz Qresi e t <br /> AFFIANTS NAME - AFFIANTS TITLE <br /> ' <br /> TAKEN.SWORN AND SUBSCRIBED TO BEFORE ME this/4/ day of 0C- i° <br /> Personally Known or Produced Identification C/ <br /> Type of identification 1' L 2 G <br /> (Affix seal here) <br /> N• v.-Y P.•=LIC(name printed or typed) <br /> •sr°"a ,EKTORAYALA <br /> MYCOMMON 1FF911313 <br /> • ''ar'• EXPIRES:October 3,2019 <br /> ,;,„" sound 1trl?.01/2C2ry Sento <br /> Dr1412E4 28.2010 1 of 7 <br /> S 0 E <br />