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<br />Appendix H
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<br />NON-COLLUSIVE AFFIDA VIT
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<br />State of ~)
<br />County of 11", &ad1
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<br />Antonio J. Grau
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<br />being first duly sworn, deposes and says that:
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<br />(1) He/she is the (Owner, Partner, Officer, Representative or Agent) of the Bidder
<br />that has submitted the attached Bid;
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<br />(2) He/she is fully informed respecting the preparation and contents of the attached Bid and of all pertinent
<br />circumstances respecting such Bid;
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<br />(3) Such Bid is genuine and is not a collusive or sham Bid;
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<br />(4) Neither the said bidder nor any of its officers, partners, owners, agents, representatives, employees or
<br />parties in interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or
<br />indirectly, with any other Bidder, firm, or person to submit a collusive or sham Bid in connection with the Work for
<br />which the attached Bid has been submitted; or to refrain from bidding in connection with such Work; or have in any
<br />manner, directly or indirectly, sought 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, or to fix any overhead, profit, or
<br />cost elements of the Bid price or the Bid price of any other Bidder, or to secure through any collusion, conspiracy,
<br />connivance, or unlawful agreement any advantage against the City of Sunny Isles Beach, or any person interested in
<br />the proposed Work;
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<br />(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion,
<br />conspiracy, connivance, or unlawful agreement on the part of the Bidder or any other of its agents, representatives,
<br />owners, employees or parties in interest, including this Affiant.
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<br />(.../ SIG TURE OF AFFIANT
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<br />State of F-I 0 .e..., ,k../ County of ~-A-- \ Ii', bl!;f2d 1
<br />Sworn to and subscribed before me this ::L. day of Ht+;J ~
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<br /><)IL-,I\~\-L'l.-- ~ 0llLt K\,)\ atL
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<br />Antonio J. Grau
<br />(Printed or Typed Legal Name of Affiant)
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<br />, 2007 by
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<br />Notary Seal:
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<br />No,"ry', N,me P<;nted, 57ed DC Typed
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<br />Personally Known: or Produced Identification _
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<br />Identification Produced
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<br />,J.~ [; f!y&'(Z)/itliL
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<br />....;,;j\~~~~ SANDRA D. BLACKMAN
<br />f.~?o'/,;;,\~; MY COMMISSION # DD 572289
<br />~.~.~~j EXPIRES: August 14, 2010
<br />--t.r;h;.,i\llf.i" Borns.d lhru Notary Public Underwriters
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<br />4/23/2007
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<br />City of Sunny Isles Beach: Request for Proposal - Audit Services
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