|
<br />
<br />NON-COLLUSION AFFIDAVIT
<br />
<br />Or $U'"
<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 />COUNTYOF~/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 />~ Y~9 . C;-Er~(/R/7Y sm vi a;s ZVe
<br />(Name of Corporation, Partnership, Individual, etc,)
<br />
<br />a, cf)/2POf2ATION'
<br />(Type of Business)
<br />
<br />, formed under the laws of F.LOR 1.2>4
<br />(State)
<br />
<br />of which he is
<br />
<br />~~/.2)EN7
<br />(Sole Owner, Partner, 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 />OLAL~A-A/ SffO/<t//\/3/
<br />AFFIANT'S NAME
<br />
<br />PRES/2)GV7'
<br />AFFIANT'S TITLE
<br />
<br />o h'l/t M ",,--...j j'l
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this ~day of~, 20,_
<br />Personally Known ~ or Produced Identification
<br />
<br />Type of identification
<br />
<br />(Affi, ",' h're)~
<br />
<br />\~~-
<br />
<br />Ol...UwA-fO-{/~ LfiPijM
<br />
<br />NOTARY PUBLIC (name printed or typed)
<br />
<br />\llI",
<br />",,~~., p~,,/ ~
<br />{~'A'>f.'~
<br />.~. ."'::
<br />"">:.,.,,~~.
<br />';t"OFf\.o,'
<br />""11"
<br />(i07) 398-0153
<br />
<br />OLUWATOYIN LADITAN
<br />MY COMMISSION # 00848686
<br />EXPIRES February 10.2013
<br />FloridaNotaryService,com
<br />
<br />DECEMBER 28. 2010
<br />
<br />1 of 7
<br />
|