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<br />NON-COLLUSION AFFIDAVIT
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<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
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<br />STATE OF FLORIDA
<br />COUNTY OF Miami - Dade
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<br />The undersigned being first duly sworn as provided by law, deposes, and says:
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<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,
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<br />The undersigned is authorized to make this Affidavit on behalf of,
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<br />CSA Central, Inc.
<br />(Name of Corporation, Partnership, Individual, etc,)
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<br />a,
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<br />Corporation
<br />(Type of Business)
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<br />, formed under the laws of Florida
<br />(State)
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<br />of which he is Senior Vice President
<br />(Sole Owner, Partner, President, etc,)
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<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,
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<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 indirj3ctlY',submitted i~" d or the contents thereof, or divulged information or data relative thereto, to any association or
<br />to any member /e~thereOf. .
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<br />Senior Vice President
<br />AFFD AFFIANT'S TITLE
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<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this 28 th day of November
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<br />Personally Known x
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<br />or Produced Identification
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<br />Type of identification
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<br />(Affix seal here)
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<br />""""'" DINA K, RHYMES
<br />,,~~~'1 PUS'I, 'd
<br />/P. """\\/10"-.. Notary Public - State of FIOri a
<br />~.: A\J:. ~ My Comm, Expires Aug 16. 2014
<br />~"'~. - . "vf Commission # DO 986056
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<br />"'~Ni,~.\?,'" 80nded Through National Notary Assn
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<br />Dina K. Rhymes
<br />NOTARY PUBLIC (name printed or typed)
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<br />DECEMBER 28, 2010
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