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<br />
<br />NON-COLLUSION AFFIDAVIT
<br />
<br />Or ~\J'"
<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 />STATE OF FLORIDA
<br />COUNTY OF \>A: ,\).f'"
<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 />U IV \ 6)vE OM i<TFR.r / AJ C.
<br />(Name of Corporation, Partnership, Individual, etc.)
<br />
<br />aTRf\I\JS-PoQIt.\ Tlo AJ
<br />(Type of Business)
<br />
<br />, formed under the laws of
<br />
<br />FLOtt, bA-
<br />(State)
<br />
<br />of which he is
<br />
<br />SoLe
<br />
<br />()v..JAJ~ .
<br />(Sole Owner, artner, President, etc.)
<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 refrain from Bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication
<br />or conference with any person, 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 Bids described above true; and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph
<br />10,2, has directly or indirectly submitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or
<br />to any member or agent thereof,
<br />
<br />I<A-N~Y ~(TH
<br />AFFIANrS NAME
<br />
<br />()wtJt~
<br />AFFIANrS TITLE
<br />
<br />, \b
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this a. ~ day of
<br />
<br />~ O\..--t
<br />"
<br />
<br />,20U
<br />
<br />Personally Known
<br />
<br />v
<br />
<br />or Produced Identification
<br />
<br />Type of identification
<br />
<br />(Affix seal herl~k,.. RICHARD.A:NZERiBE........~
<br />,>'~~~~::!:;"" Comm# 000737586 ~
<br />"~m<;<.~
<br />~~~;i Expires 12/14/2011 E
<br />. ~/J;f,f,f;:.~ Florid<:l Notary Assn" Inc
<br />,'I '" lUI II ..11" . '.~". .: c.. '!II" .......... I' I'
<br />
<br />NOTARY PUBLIC (name printed or typed)
<br />
<br />DECEMBER 28,2010
<br />
<br />10f7
<br />
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