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<br />
<br />STATE OF FLORIDA
<br />
<br />COUNTY OF
<br />
<br />Fe-
<br />
<br />NON-COLLUSION AFFIDA VIT
<br />
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />Sunny Isles Beach, FL 33160
<br />Telephone: (305) 947-0606 Fax: (305) 949.3113
<br />
<br />t-ttOJv~ \ Oo.dt; ,
<br />
<br />The undersigned being first duly sworn as provided by law, deposes, and says:
<br />
<br />This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be
<br />relied upon by said County, in any consideration which may give to and any action it may take with respect to this Bid.
<br />
<br />The undersigned is authorized to make this Affidavit on behalf of,
<br />
<br />Cl\~)rL~ OS~ Cd2-P~.
<br />
<br />(Name of Corporation, Partnership, Individual, etc.)
<br />
<br />'. ~Jmn ~ ).'~'d ""dd"'~'f~
<br />
<br />(Type of Business) (State)
<br />
<br />of which he is (lonO-[' - "tLQ > ~g,p l (~ - &\;~u.~
<br />(Sole Owner, Partner, President, etc,) 01
<br />
<br />Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10,2, nor anyone else to the knowledge of the
<br />undersigned, have themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any
<br />department or employee therein, or any officer of the City of Sunny Isles Beach, Florida is directly interested therein.
<br />
<br />This Bid is genuine and not collusive or a sham; the person, firm or corporation named above in Paragraph 10.2 has not colluded. conspired,
<br />connived or agreed directly or indirectly with any proposers or person, firm or corporation, to put in a sham Bid, or that such person, firm or
<br />corporation, shall refrai Bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication
<br />or conference wit yon, firm or corporation, to fix the prices of said Bid or Bids of any other proposers; and all statements contained in
<br />the Bid or Bid ese' a above true: and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph
<br />10.2, has dir ctly 0 directly submitted. said Bid or the contents thereof, or divulged information or data relative thereto, to any association or
<br />to any me er nt thereof. ._
<br />
<br />
<br />fu~ A~~~frll~d/C),u~efK
<br />
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this I b day of M. QJ,,~
<br />
<br />Personally Known
<br />
<br />Type of identification
<br />
<br />(Affix seal here)
<br />
<br />,20qJ,
<br />
<br />or Produced Identification 'X
<br />
<br />D \ 1=-\ .c '2 ~Y~2oS2 i q 00
<br />
<br />C \QM.c!PQ 6Q[ Ct\-eZ 0
<br />
<br />NOTARY PUBLIC (name printed or typed)
<br />
<br />........... CLAlJUIA oALAREZO
<br />,,~v~c.. II,
<br />lm~ 6':t\ Notary PubliC . State of FIOdlII
<br />{. ,! My Comm Expires Noy 2. 2014
<br />\' il/ Commlnlor. , E f 39132
<br />'.:1,Rr,r.\.... Bonded Tllfollllll ~llilnal AIM.
<br />
<br />DECEMBER 28,2010
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