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<br />- <br /> <br />...... <br /> <br />c <br /> <br />('.... <br />..... <br /> <br /> <br />NON-COLL USION AFFIDAVIT <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 />0' HiN <br /> <br />STATE OF FLORIDA ) <br />COUNTY OF "0 C'"o~~ <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 />C OQ,,"'b~o-\ CO ~o\-~~~'. _ ~ . b O'......lL.\Q9 C"'n~""o\- .J:~c.. <br />(Name of Corporation, Partnership, Individual, e c.) <br /> <br />a, <br /> <br />c.o,..~o~~ ;,Q.... <br />(Type of Business) <br /> <br />, formed under the laws of ~\o.,.; ~ " <br />(State) <br /> <br />of which he is <br /> <br />Y"'f.."'!:>>~~Q -' <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 confere ith any rs n, firm or co ation, to fix the prices of said Bid or Bids of any other proposers; and all statements contained in <br />the Bid Bid descr' ed a ve tr . d fu her; neither the undersigned. nor the person, firm or corporation named above in Paragraph <br />1 D.2, h s direc !y or i 'rectly sub lit aid B or the contents thereof, or divulged information or data relative thereto, to any association or <br />to an~ membe or r of <br /> <br /> <br />y .,......~ ~ ~ e..-~ <br />AFFIANT'S TITLE <br /> <br />TAKEN. SWORN AND SUBSCRIBED TO BEFORE ME this ~ day of '3 u..",",," <br />Personally Known vi or Produced Identification <br /> <br />, 201lj. <br /> <br />Type of identification <br /> <br />(Affix seal here) <br /> <br />~~ <br /> <br />--b~&it-. <br />~~:~li} <br />~~~~~8f:~~\'\ <br /> <br />JENNIFER CAMERON <br />MY COMMISSION t DO 641514 <br />EXPIRES: Marth 25. 2013. <br />Bonded Thro Notart Public UooBrwnters <br /> <br />DECEMBER 28, 2010 <br /> <br />1 of 10 <br />