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<br />NON- COLLUSION AFFIDAVIT
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<br />City of Sunny Isles Beach
<br />z 18070 Collins Avenue
<br />Sunny Isles Beach, FL 33160
<br />Telephone: (305) 947 -0606 Fax: (305) 949 -3113
<br />STATE OF FLORIDA /� )
<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 />M A-0 tt K' S ,LAW CN S ir, 8- P t Q G T �
<br />(Name of Corporation, Partnership, Individual, etc.)
<br />a, L At A'b S Ca{ 0 formed under the laws of I -L,
<br />(Type of Business) (State)
<br />of which he is P kE;�s I DF-f
<br />(Sole Owner, 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 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 di ctly or indirect ubmitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or
<br />to any mem e r aath
<br />AFFIANT'S NAME AFF T�l_E r Q iV
<br />TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this ` day of .2049
<br />Personally Known & — or Produced Identification ,
<br />Type of identification
<br />(Affix seal here) ,,,
<br />,► Y, Tammy Anderson
<br />`q�CAMMISSION #EE ®!6997
<br />�!•i� e, wWwEAARONNO ARY.Com
<br />40TARY PUB 41 printed or typed)
<br />DECEMBER 28, 2010 1 Of 10
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