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NON - COLLUSION AFFIDAVIT <br />~FC s�♦ FLO%` <br />of SUN �N <br />STATE OF FLORIDA ) <br />COUNTY OF -Ulw � r& ) <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 />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, Partnership, Individual, etc.) <br />a, 7 \ 1 CJ�- 2c`"k O0 ) , formed under the laws of <br />(Type of Business) (State) <br />of which he is Sty a\r� <br />(Sole Or, 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 o, agent therecff <br />i <br />L �?'\0 <br />AFFIANT'S NAM AF (ANT'S TITLE <br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this day of �—k CA4 20A. <br />Personally Known or Produced Identification <br />Type of identification <br />(Affix seal here) <br />'SNS:.•U'' YVE I 1 C SANZ <br />MY COMMISSION # DD 993086 <br />•. ,, 7 EXPIRES: September 18, 2014 <br />Bonded Thru Notary Public Underwriters <br />"'s"--I� <br />NOTA Y PUBLI (name printed or t d) <br />DECEMBER 28, 2010 1 of 7 <br />