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<br />. <br />I.' <br />. <br />. <br />. <br />'. <br />I. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br />. <br /> <br />NON-COLLUSIVE AFFIDA vir <br /> <br />State of <br /> <br />~M'61J'~;Q.) <br />\ <br /> <br />County of <br /> <br />~~t--\.~\.J ) <br />I <br /> <br />~UI".~U \-\. \-\o.a.M'S, .p. ~. <br />and says that: \ <br /> <br />being first duly sworn, deposes <br /> <br />(1) He/she is the (Owner, Partner, Officer, Representative or Agent) of the Bidder that has <br />submitted the attached Bid; <br /> <br />(2) He/she is fully informed respecting the preparation and contents of the attached Bid and <br />of all pertinent 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 bickleI' nor any of its officers, partners, owners, agents, representatives, <br />employees or panics in interest, including this affiant, have in any way colluded, conspired, <br />connived or agreed, directly or indirectly, with any other Bickler, 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 Bickler, 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 other Bickler, <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 /> <br />(5) 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 /> <br />A~~~ <br /> <br />SIGNATURE OF AFFIANT <br /> <br />IT ~~~ r\. \-1aa..-\;\s, '}>, ~ . <br />(Printed or yped Legal Name of Affiant) <br /> <br />State of PA County of n1~N'6CfrIL fLc1 <br />Sworn to and subscribed before me this ~+ 'Jdayof <br /> <br />~ t-'\o ""'^-4, H. H:iC. (,1 ~ } f. 'l <br /> <br />(YllLC/ <br />(J <br /> <br />, 2007 by <br /> <br />r;/llt/C~.s ;! AN/Jx <br />Notary's Name Printed, Stamped or Typed <br /> <br />/ or Produced Identification <br /> <br />Notary Seal: <br /> <br />Personally Known: <br /> <br />Identification Produced <br /> <br />COM 0 <br /> <br /> <br />07.0./-02 G/'II rllg Sns f{/'I"i{age PI.: (jarage IJirl (RJitJ <br /> <br />Page 7 of 7 <br />