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<br /> - NON - COLLUSION AFFIDAVIT
<br /> ® V - I
<br /> City of Sunny Isles Beach
<br /> _ 18070 Collins Avenue
<br /> %.- D''•F Los'o 4` Sunny Isles Beach,FL 33160
<br /> c''I-or suo'''o 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 /> `ICO,/s .-NrE/ AT/aNA-L coa#0
<br /> (Name of Corporation,Partnership, Individual,etc.)
<br /> a, ,formed under the laws of /42.19/21.D4
<br /> (Type of Business)s)-
<br /> �-, (State)
<br /> �
<br /> of which he is 1/c��ji�z-rrea o F ne -2 .o .
<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 /> all 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 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 /> 17 -LA Of of Sf'C -
<br /> AFFIANT'S NAME AFFIANT'S TITLE
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this /l'7 day of Ma(/ ,201
<br /> Personally Known 17-- or Produced Identification /
<br /> Type of identification
<br /> (Affix seal here) ft:A• 01,..
<br /> NOTARY PUBLIC(name printed or typed)
<br /> ,•.,,PRypV�• RONALD STERLING ANDERSON
<br /> . `�; Notary Public -State of Florida
<br /> Commission # GG 046746 i
<br /> • ,.o�`�A;? My Comm.Expires Nov 14,20201
<br /> ,,,,,, Bonded through National Notary Assn.
<br /> II ,.............„,,,,,
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