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<br />NON-COLLUSION AFFIDA VIT
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<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />Sunny Isles Beach, Fl 33160
<br />Telephcne: (305) 947-0606 Fax: (305) 949-3113
<br />
<br />STATE OF FLORIDA )
<br />COUNTY OF l)(ll'vJ<l,d )
<br />
<br />The undersIgned being firs! duly 8worn as provIded by law, deposes, and says:
<br />This Affidavit Is made with the knowledge and Intent that ills to be filed with the CIty of Sunny Isles Beach City CommissIon and that It will be
<br />reUed upon by saId County, In any conslderallon whIch may give to and any aclion It may take With respecllo thIs BId.
<br />The undersigned Is authorized 10 make this Affidavit On behalf of,
<br />
<br />
<br />
<br />()lJ
<br />fL-\..)
<br />
<br />(State)
<br />
<br />of which he Is
<br />
<br />tJtf\
<br />. PartnershIp, Individual, etc.)
<br />
<br />e, CA' I.... hi ~1NI. . fQ(med under the laws of
<br />
<br />off;;:;OfBusness)
<br />
<br />(Sore Owner, Partner, Presidenl, e1c.)
<br />
<br />Neither the undersIgned nor any person, firm, or corporation named In above Paragraph 10.2, nor anyone else 10 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 Islas 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 corpora lion, to put In a sham Bid. or that such person. firm or
<br />corporatlon, shall refrain from Bidding, and has nolln any menner, dJreclly 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; neJlhElr the undersigned. nor the person, firm or corporation named above In Paragraph
<br />10.2, has dlreclly or Indirectly submitted said Bid or the contents thereof. or dIvulged Information or data relative thereto, to any association or
<br />(0 any member or agent thereof.
<br />
<br /><~-:- <~)--"V,,,,.// Cw..d Davcrkd7rW'
<br />
<br />(Ff...IAN '8 NAME " AFFIANT'S TITLE 'J - U
<br />"--' J4-fAc- f::4'Y~~ "
<br />
<br />TAKEN, SWORN ANO SUBSCRIBED TO BEFORE ME this ,11 day of f-&.. lA.!i.f'l ,20~J.1 '
<br />. ,
<br />Personally Known v"' or Produced Identification
<br />
<br />Type of iden!lflcatfon
<br />
<br />(Affix seal here)
<br />
<br />,,~'o{i ~ VICKIELHfROLD ~
<br />{.f ;oj MY CO/.\~ISSION I EE 0821"
<br />~' 'Y EXPIRES: ApollO, 2llt5
<br />~.p,r.,&;o BorKledThru Notary Pl1Ille Unil6lWl'ilers.
<br />...
<br />
<br />\.1.uu.r,' ~. i-\ ~/I ;~I 111
<br />NOTARY PUBLIC (name printed or typed)
<br />
<br />DECEN8ER 28. 2010
<br />
<br />10f7
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