|
<br />....,
<br />
<br />.
<br />
<br />......
<br />
<br />.
<br />
<br />...,
<br />
<br />.
<br />
<br />.......
<br />
<br />.
<br />
<br />.....
<br />
<br />.
<br />
<br />.,
<br />
<br />.
<br />
<br />...,
<br />
<br />.
<br />
<br />....,
<br />
<br />.
<br />
<br />"""
<br />
<br />.
<br />
<br />...,
<br />
<br />.
<br />
<br />-.
<br />
<br />.
<br />
<br />....,
<br />
<br />.
<br />
<br />..,
<br />
<br />.
<br />
<br />..,
<br />
<br />.
<br />
<br />'"'"
<br />
<br />.
<br />
<br />....,
<br />
<br />.
<br />
<br />-..
<br />
<br />.
<br />
<br />...,
<br />
<br />.
<br />
<br />..,
<br />
<br />.
<br />
<br />
<br />Or sutl
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF Florida
<br />
<br />NON-COLLUSION 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 />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 />of which he is President
<br />
<br />Tally Engineering, Inc.
<br />(Name of Corporation, Partnership, Individual, etc.)
<br />
<br />a, Corporation
<br />(Type of Business)
<br />
<br />, formed under the laws of Florida
<br />(State)
<br />
<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 />1QJ' directly or indirectly ubmitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or
<br />to,a y m mber or agent thereof.
<br />
<br />,--)1"\-
<br />
<br />Pirooz Borojerdi
<br />AFFIANT'S NAME
<br />
<br />
<br />President
<br />AFFIANT'S TITLE
<br />
<br />July
<br />
<br />,~~~U
<br />
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this ~ day of
<br />Personally Known X or Produced Identification
<br />
<br />Type of identification
<br />
<br />(Affix seal here)
<br />
<br />L{Ml~,
<br />
<br />Marilyn Medina
<br />NOTARY PUBLIC (name printed or typed)
<br />
<br />........"r....',. MARILYN MEDINA
<br />!*~A~f: MY COMMISSION # EE 029888
<br />~.~.;rl EXPIRES: September 27, 2014
<br />"!,1..iif.~~ Bonded Thru Notary Public Underwriters
<br />
<br />DECEMBER 28, 2010
<br />
<br />1 of 7
<br />
|