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<br />NON - COLLUSION AFFIDAVIT
<br />City of sunny Isles Beach
<br />18070 Wins Avenue
<br />a,..
<br />Sunny Isles Beach, FL 33160
<br />Telephone: (305) 947 -0606 Fax (3W 949 -3113
<br />STATE OF FLORIDA J
<br />COUNTY OF)
<br />The undersigned being first duly sworn as provided by law, deposes, and says:
<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 />The undersigned is authorized to make this Affidavit on behalf of,
<br />�►aGk I P
<br />e LC
<br />(Name of/Corporation, Partnership, Individual, etc.)
<br />a, _,formed under the laws of ��
<br />(Type of Business) (State)
<br />of which he is F ''on 'V n vat W6 r-
<br />poldowAer, Partner, President, etc.)
<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 />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 indireedy with any proposers or person, firth or corporation, to put in a sham Bid, or that such person, firth or
<br />corporation, shall refrain from Bidding, and has not in any manner, directly or indWactly, sought by agreement or collusion, or communication
<br />or conference with any person, firm or corporation, to fox 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 />AFFIANrS NAME AFFIANT's TITL
<br />TAKEN, SWORN ANDSCRIBED TO BEFORE ME this l _day of 1'AO c 20W Personal) Known t/ or
<br />Y Produced Identification
<br />Type of identification
<br />(Affix seal here) , tia"'s''•,, JASON R.WESTFORT Ic
<br />My COMMISSION 8 DD 992109 _
<br />EXPIRES: June 13, 2014 NOT
<br />Bonded Tnru Notary Palle Underwriters
<br />DECENuR 28, 2019
<br />1 of 7
<br />printed or typed)
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