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<br />o
<br />
<br />NON-COLLUSIVE AFFIDA VIT
<br />
<br />State of Florida )
<br />
<br />County of
<br />
<br />Broward
<br />
<br />)
<br />
<br />Charles A. Michelson
<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 />C)
<br />
<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;
<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 />othe~r of its agents, representatives, owners, employees or parties in interest, including this
<br />Affi ftl. , ill _
<br />
<br />}A.Jl.fl'- Charles A. Michelson
<br />SIGNATURE OF AFFIANT (Printed or Typed Legal Name of Affiant)
<br />
<br />State of Florida County of Broward
<br />Sworn to and subscribed before me this 21st
<br />
<br />day of Auaust
<br />A . \1\1\ \ ,-,k~J s; 0 '""'-
<br />
<br />, 2007 by
<br />
<br />(' j "Q\'" \< ~
<br />~~i.-~-~~
<br />
<br />Notary's Name Printed, Stamped or Typed
<br />
<br />Notary Seal:
<br />
<br />RHONOA N. MILROT
<br />~~ MY COMMISSION #00562447
<br />("Fl'\,,' EXPIRES: AUG 22, 2010
<br />\~ Bonded through 1st State Insurance
<br />
<br />Personally Known: XXXXX
<br />
<br />or Produced Identification - --
<br />
<br />Identification Produced N/A
<br />
<br />C)
<br />
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