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<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 />STATE OF FLORIDA )
<br />COUNTY OF t'\\ll\W ~ ~Qlt..-
<br />
<br />The undersigned being first duly sworn as provided by law, deposes, and says:
<br />
<br />This Affidavit is rnade 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 />CAW\'P~S + L.D ~V\I\L{.Vrr'1 ST~ /I~J
<br />(Name of Corporation, Partnership, Individual, etc,)
<br />
<br />a, {A M ~ L-\ ~ \ LLT1{ (.4" formed under the laws of _fLo 1<1 Oft
<br />(Type of Business) (State)
<br />
<br />of which he is
<br />
<br />?~1~6LPAL--
<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 />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 />
<br />c ~ [k -ff- -P~/f\JCI?Av
<br />AFFIANT'S NAME I' ~ t/fI / AFFIANT'S TITLE
<br />
<br />TAKE~ND SUBSCRIBED TO BEFORE ME th,,z-l ~,y of A f~\ !
<br />Personally Known"" or Produced Identification ;
<br />Type of identification, f)U V€."\-.-LA (.A/J '::J~.
<br />
<br />, 20;L--
<br />
<br />(Affix seal here)
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<br />
<br />
<br />
<br />o..",.~~ P1l8<t,
<br />~ .
<br />~ }
<br />~Of....d"
<br />
<br />Public State of Florida
<br />Notary
<br />StanleY Moore 6464
<br />My Commission 0082
<br />Expires 09/28/2012
<br />
<br />DECEMBER 28, 2010
<br />
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