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SJNNY/S04' 490 <br /> FJ <br /> NON - COLLUSION AFFIDAVIT <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> '9 <br /> 9' FL Oa` 4''' Sunny Isles Beach,FL 33160 <br /> or suN " Telephone:(305)947-0606 Fax:(305)949-3113 <br /> STATE OF FLORIDA FL ) <br /> COUNTY OF to%Qo-tt " V <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 /> 6a.t64tNlew C.A4 t.scvoe se i J LC€ , L c. <br /> (Name of Corporation,Partnership,Individual,etc.) <br /> a, Caw o rt Arta ,formed under the laws of FL0114°A <br /> I (Type of Business) (State) <br /> V' <br /> of which he is ca• ice Piz es. be`ir <br /> (Sole Owner,Partner,President,etc.) <br /> Neither the undersigned nor any person, firm, or corporation named above nor anyone else to the knowledge of the undersigned, have <br /> themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any department or <br /> ® <br /> 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 has not colluded,conspired,connived or agreed <br /> directly or indirectly with any proposers or person, firm or corporation, to put in a sham Bid, or that such person, firm or corporation, shall <br /> refrain from Bidding,and has not in any manner,directly or indirectly,sought by agreement or collusion,or communication or conference with <br /> any person, firm or corporation, to fix the prices of said Bid or Bids of any other proposers; and all statements contained in the Bid or Bids <br /> described above true; and further; neither the undersigned, nor the person, firm or corporation named above has directly or indirectly <br /> submitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or to any member or agent <br /> thereof. <br /> A4f&H46L Doe n- C. VP <br /> AFFIANT'S NAME AFFIANT'S TITLE <br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 21 day of vV ,2017. <br /> Personally Knownib µe_, or Produced Identification <br /> Type of identification <br /> (Affix seal here) I`,/'laC n p jA l <br /> NOTARYCX�PI Bl (IIC(nameWprinted or typed) <br /> , LUISANGELAJIMENEZ <br /> 41. <br /> i '. MY COMMISSION 1 FF 913313 <br /> -ftii7 EXPIRES:August 26,2019 <br /> 4;84./W Bonded Thru Notary Pu*Underwriters <br /> 41111 <br /> 1 of 10 <br />