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SJNNY'�SlF <br />NON - COLLUSION AFFIDAVIT <br />.n <br />City of Sunny Isles Beach <br />p' 18070 Collins Avenue <br />Oa ° Sunny Isles Beach, FL 33160 <br />Telephone: (305) 947 -0606 Fax: (305) 949 -3113 <br />STATE OF FLORIDA ) <br />COUNTY OF V2a` lAW ) <br />The undersigned being first duly sworn as provided by law, deposes, and says: <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 />The undersigned is authorized to make this Affidavit on behalf of, <br />(Name of Corporation, Partw6rship, Individual, etc.) <br />a, ��'/.d� , formed under the laws of Cad -rAW <br />(Type of Business) (State) <br />of which he is '0 Co-�0,/j�f�l� <br />(Sole Owner, Partner, President, etc.) <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 />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 />"Aeze2i-�� <br />i <br />FFIANT'S N E AFFIANT'S TITLE <br />TAKEN, SWORN AND SUBS RIBED TO BEFORE ME this Z day of 0 "r a 20%1 <br />own 1/ or . <br />Personally Kn Produced Identification , <br />Type of identification <br />(Affix seal here) <br />TEOTIMO OSORIO <br />MY CONWSSION # 8620976 <br />ENPIRFS: October 28, 2014 <br />bdU43NMARY FI. Notary Dorn nt Assoc. Co. <br />� �afl; -" n 4 - - <br />NOT LIC (name printed or typed) <br />DECEMBER 28, 2010 1 of 7 <br />