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<br />
<br />NON-COLLUSIVE AFFIDAVIT
<br />
<br />StaLe of
<br />
<br />Florida_)
<br />
<br />County of
<br />
<br />M'~Mi. 'DAcAt..
<br />
<br />_, 3~FFIt~ MPlll.c..I.'.:s,j~h."D.. - Via.. PlI.e511)~!'l't being first duly swom, ueposes
<br />and says that:
<br />
<br />(1) He/she is the (Owner, Partner, Officer, Representative or AgenL) of the Bidder that has
<br />sltbmitted the attached Ilid; President / Owner
<br />
<br />(2) He/she is fully informed respecting the preparation and contents of the attached Bid and
<br />of all peltincnt 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 01' parties in interest, including this affiant, have in any way colluued, conspired,
<br />connived or agreed, directly or indirectly, with any other Bidder, firm, 01' person to submit a
<br />collusive or sham Bid in cOlmection with the Work for which the attached Bid has been
<br />submitted; or to refrain from bidding in connection with sLlch 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 clements of the Bid price or the Bid price of any oLher Bidder,
<br />or to secure through any collusion, conspiracy, connivance, or unlawful agreement allY
<br />advantage against the City of Sunny Isles Beach, or any person interested in the proposed Work;
<br />
<br />(5) The price or prices quoted in the attached Bid are fair and propcr and are not tainted by
<br />any collusion, conspiracy. connivance, or unlawful agreement on the part of the Bidder or any
<br />other of iLs agents, representatives, owners, employees or parties in interest, including this
<br />
<br />
<br />7~~ 11 ~e../-
<br />. J\'I'l!~' AFFIANT .
<br />
<br />State of FlOrida CUllnLyof 1f}1t'ill'l_ DqdG
<br />SWOrtlto and subscribed before me this f4jiJ day of ;)./W
<br />
<br />Jr:.' //1 'I II. ILIc:jL({ j, Vile fN'J1Ci("';/,.. (~/l_'Jc.'//lIlq L:'1ql"l~*'" j / J:I.(',<(....
<br />../ ,/ , L l / ...../ /
<br />
<br />llC(.(/.(t-<./)/ /tc:-d(l...{<ctc-//. ~(Jlar Seal:
<br />Notary's Namc Printed, Stuu1ped or Typed ~.~
<br />i"f ;
<br />Personally Known: __ ^- _ or Produced IdenLification _ Type: _
<br />
<br />--Xd-f~~s
<br />(Printeu or Typed Legal Name of Affiant)
<br />
<br />, 2007 by
<br />
<br />j,IC'
<br />
<br />
<br />RICHARD 8, BOCHNOV1CH
<br />MY COMMISSION' DO 6040566
<br />EXPIRES: Marcil 16, 201 1
<br />Bondocl ThN _.., N>Ic: ~
<br />
<br />Page 9 or 9
<br />RFQ 07-03-01 Engincering Srvs Bridgc Rcvised (Addendum,l)
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