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<br />- <br /> <br /> <br />NON-COLLUSION AFFIDAVIT <br /> <br />City of Sunny Isles Beach <br />1lHl70 Collins Allenue <br />Sunny Isles Beach. FL 33160 <br />Telephone: (305) 947-0006 Fax: (305) 949-3113 <br /> <br />STATE OF FLORIDA ) <br /> <br />COUNTY OF ~1A.'l ~~ <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 tiled 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 10 make this Affidavit on behalf of. <br /> <br />~e -BG GBo--tf' <br /> <br />(Name of Corporation. Partnership, Individual. etc.) <br /> <br />L.L. C <br /> <br />a. <br /> <br />LL-C- <br /> <br />. fonned under the laws of <br /> <br />~ <br /> <br />(Type of Business) <br /> <br />(State) <br /> <br />of which he is <br /> <br />~~ <br />(Sole r, rlner. President. etc.)' <br /> <br />Neither the undersigned nor any person, finn, 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 directty 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 direcUy or indirectly submitted said Bid or the contents thereof. or divulged information or data relative thereto, to any associa1ion or <br />to any member or agent thereof. <br /> <br />tvy ~(f0 <br />AFFIANT'S NAME <br /> <br />AFFIANT~ <br /> <br /> <br />TAKEN. SWORN AND ~CRIBED TO BEFORE ME this Z day of <br />Personally Known or Produced Identification ; <br /> <br />J u/1 <br /> <br />.200_. <br /> <br />Type of identification <br /> <br /> <br />(Affix seal here) <br /> <br />.~~'fi;,", !\'RYSTAL COURCHENE <br />/~~.. ~\ MY COMMISSION # EE 000266 <br />~~ ;~ EXPiRES: October 12.2014 <br />~'1;j'" 'Ils.~ Boorled l~ Nola<)' Public UnderWIlters <br />'I'fif..~'- .~. <br /> <br />DECEt.tlER 28. 2010 <br /> <br />1 of 10 <br />