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<br />::. NON- COLLUSION AFFIDAVIT
<br />City of Sunny Isles Beach
<br />18070 Collins Avenue
<br />c'9t11 oe`4ad °` sunny Isles Beach, FL 83180
<br />'r or Fu„ aN Telephone; (306) 947.0808 Farc (306) 948.5118
<br />STATE OF FLORIDA )
<br />COUNTYQF�_)
<br />The undersigned being first duly swam as provided by law, deposes, and says.
<br />This Aifldavit Is made with the knowledge and Intent that h Is to be flied 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 respectto this Bid.
<br />The undersigned Is authorized to make this Aflidevit on behalf of,
<br />4:z:)k0 r��45 '1 3RQ
<br />(Name of Corporation, Partnership, Individual, eto.)
<br />e, 3'C eSA Q-U M A+ , formed under the jaws of I n r Jai
<br />(Type of Business) (State)
<br />ofwhtoIn h la �q V1-
<br />(Sole Owner, Partner, Presldent, 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 solloited or employed anyone else to sollott 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 />This Bid is ganulne and not collusive or a sham; the person, firm or corporation named above In Paragraph 102 has not colluded, coneplred,
<br />connived or agreed directly or indirectly with any proposers or parson, firm or corporation, to put In a sham Bid, or that such person, firm or
<br />corporation, shall refrain from Bidding, and has riot In any manner, directly or Indirectly, sought by agreement or collusion, or aommuntoatlon
<br />or conference with any person, firm or corporation, fn fix the prices of said Bid or Birds of any other proposers; and all statements contained In
<br />the Aid or Bide 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 sold Bid or the contents thereof, or divulged fiformatlon or date relative thereto, to any assoctaflon or
<br />to snv membw&Qantftreof.
<br />are-5i APY 4
<br />AFFIANT'TITLE'
<br />M I \/ A-6—W 12-0
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE M8 this l day of S 0 +n � , 2001:L
<br />Personally Known_ or Produced identification
<br />'type of Identificattiion � l t r21 veaS td &0re-
<br />(Affix seal here)
<br />NOTARY PUBLIC (name printed or typed)
<br />Comm# t3CtQ$jiQ3it2
<br />End 6151/201s 77
<br />pbrWa NotaryAeen., Ins I >,
<br />9019R0914+i8iCt!1nvNe, +.+94tlR91 tl91G918911W111F ' -.
<br />�989999999919989988899999989899998999999919998
<br />MARIA SLBVAT a
<br />Deo�meen20,2010 1 of 7 S Mu�r zm# ®D0880302 lrea 5/31/2013 tt
<br />Ft��,da Notary Assn., Inc m
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