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NON-COLLUSION AFFIDAVIT
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF \:::::h.. C~ (.
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<br />)
<br />)
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<br />The undersigned being first duly sworn as provided by law, deposes, and says:
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<br />10.1. This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny
<br />Isles Beach City Commission and that it will be relied upon by said County, in any consideration which
<br />may give to and any action it may take with respect to this Proposal.
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<br />10.2. The undersigned is authorized to make this Affidavit on behalf of,
<br />
<br />S~)Ztt\ Se-('~\C~S ~~('.
<br />(Name of Corporation, Partnership, Individual, etc.) ,
<br />
<br />a, ?r.- , formed under the laws of ~
<br />(Type 0 Business) (State)
<br />
<br />of which he is \.1,~'r ~ .-- YiPS " J P /\ +-
<br />(Sole Owner, Partner, President, etc.)
<br />
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<br />10.3. Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10.2,
<br />nor anyone else to the knowledge of the undersigned, have themselves solicited or employed anyone
<br />else to solicit favorable action for this Proposal by the City, also that no head of any department or
<br />employee therein, or any officer of the City of Sunny Isles Beach, Florida is directly interested therein.
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<br />10.4. This Proposal is genuine and not collusive or a sham; the person, firm or corporation named
<br />above in Paragraph 10.2 has not colluded, conspired, connived or agreed directly or indirectly with any
<br />proposers or person, firm or corporation, to put in a sham Proposal, or that such person, firm or
<br />corporation, shall refrain from proposalding, and has not in any manner, directly or indirectly, sought by
<br />agreement or collusion, or communication or conference with any person, firm or corporation, to fix the
<br />prices of said proposal or proposals of any other proposers; and all statements contained in the proposal
<br />or proposals described above true; and further; neither the undersigned, nor the person, firm or
<br />corporation named above in Paragraph 10.2, has directly or indirectly submitted said proposal or the
<br />contents thereof, or divulged information or data relative thereto, to any association or to any member or
<br />agent thereof.
<br />
<br />~1r\(~~'o .,
<br />AFFIANT'S NAME
<br />
<br />-h-C~ ~
<br />
<br />\) ') 1'1""
<br />AFFIANT'S TITLE
<br />f)~. 20~f)
<br />
<br />~~,~
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<br />TAKEN, SWORN AND ~rRIBED TO BEFORE ME this J.:3 day of
<br />
<br />Personally Known (', _ or .produced~,Ii,rltification ;
<br />Type of identification j~ ~ 1l2---~ - _ _
<br />
<br />(Affix seal here) Ei j e.e0 '~rY1 Of n G-, u e.. -V
<br />NOTARY PUBLIC (name printed or typed)
<br />
<br />
<br />8LEEN DOMINGUEZ
<br />MY COMMISSION # DO 812645
<br />_ EXPIRES: Augusl7, 2012
<br />,-- Bonded Thru Notary Public Underwriters
<br />lltl'
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<br />END OF SEmON
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<br />G k?Ji~J1~...
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<br />PAGE 85 OF 105 ~0 . r
<br />PROPOSAL No.
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