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<br />NON-COLLUSIVE AFFIDA vIr
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<br />State of FLO~D,o..)
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<br />County of
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<br />MiAMI-~)
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<br />R,s, MUf<AL-i
<br />and says that:
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<br />being first duly sworn, deposes
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<br />(I) He/she is the (Owner, Partner, Officer, Representative or Agent) of the Bidder that has
<br />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
<br />of all pertinent 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,
<br />employees or parties in interest, including this affiant, have in any way colluded, conspired,
<br />connived or agreed, directly or indirectly, with any other Bidder, 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 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 elements of the Bid price or the Bid price of any other Bidder,
<br />or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage
<br />against the City of Sunny Isles Beach, Florida, or any person interested in 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
<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 />Affiant.
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<br />SIGNA TURE OF AFFIANT
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<br />12... S . /-tV ~L/
<br />(Printed or Typed Legal Name of Affiant)
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<br />State of fUJrfll- County ofm~, ~o&e
<br />Sworn to and subscribed before me this ~I S1" day of
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<br />UM~
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<br />. 2007 by
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<br />~5 h1 u,~
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<br />eo '( \ Y1 ~tlL S-e..., k-Y
<br />Notary's Name Printed, Stamped or Typed
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<br />Personally Known: ~
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<br />or Produced Identification
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<br />Notary Seal:
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<br />""Off"
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<br />Notary Public Stale 01 FIoIida
<br />Corinthla Seiler
<br />My Commission DD538358
<br />Expires 0511412010
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<br />Identification Produced
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