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SV$NY i s 4 ej.
<br /> _A._ NON - COLLUSION AFFIDAVIT
<br /> U
<br /> ® Z
<br /> •• `�� - City of Sunny Isles Beach
<br /> 9➢< _, a� 18070 Collins Avenue
<br /> '`F '•Fops'os +`` Sunny Isles Beach,FL 33160
<br /> c''"o, sus'so Telephone:(305)947-0606 Fax:(305)949-3113
<br /> STATE OF FLORIDA )
<br /> COUNTY OF A.& 'it ( )
<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 /> ViCiv4u/orAeGLC %'a eeSIcesew/-ak/yr 5'514rm5
<br /> (Name of LZ.
<br /> Partnership, Individual,etc.)
<br /> a, LL 1 ,formed under the laws of
<br /> (Type of Business) (State)
<br /> of which he is -4971 (' l�
<br /> ole Ow r,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
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<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,h directly or indirectly submitted said Bid or the contents thereof,or divulged information or data relative thereto,to any association or
<br /> to a me ser or agent thereof.
<br /> O, • 'z� Ce,t,02/ GHQ, l/,---
<br /> AFFIANT'S NA1 E AFFIANT'S TITLE
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 16 day of ,2013
<br /> Personally Known I or Produced Identification
<br /> Type of identification
<br /> (Affix seal here)
<br /> irs4: ' %• Mtn V
<br /> RY PUBLIC(name printed or typed)
<br /> ,'' KIRSTIN D IMMELL
<br /> = MY COMMISSION#GG087854
<br /> ° -r'.• EXPIRES March 28.2021
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