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®, Item 8 <br /> Contract Forms <br /> • , <br /> NON COLLUSION AFFIDAVIT <br /> City of Sunny Isles Beach <br /> :� 18070 Cans Avenue <br /> •'� o 0.• <br /> Sunny Isles Bead,FL 33160 <br /> o.s4 Telephone:(305)947-0606 Fax(305)949-3113 <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OFnami Dade <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 wit 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 /> Bettoli Trading Corp.D/B/A Bettoli Vending <br /> (Name of Corporation,Partnership.Individual,etc.) <br /> a.Full Line Vending Operator .formed under the laws of Florida <br /> (Type of Business) (State) . <br /> of which he is Director of Operations <br /> . <br /> (SoleOwner,Partner,President,etc.) <br /> 411 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 sofidted 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.fine 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 /> Maurizio L Bettoli `` Director of Operations <br /> AFFIANTS NAME AFFIANTS TITLE <br /> TAKEN.SWORN AND SUBSCRIBED TO BEFORE ME this iCV, day of &IA4 j ,2011 <br /> Personalty Known -/or Produced Identification / • • <br /> (( <br /> Type of identification /'�t. [J L- <br /> (Affix seal here) \° <br /> l. <br /> \``\�J`F7`EIitA 5144•/ ' •TARY PUBLIC(name. 1 <br /> 3 ..$gssiayF a <br /> St)... !if 131r8t •j� <br /> �.-s, a` <br /> i'9y 1.`.. <br /> 1 0(7 <br /> 0 <br />