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<br /> ® soANY 4.6.
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<br /> NON - COLLUSION AFFIDAVIT
<br /> '. '� City of Sunny Isles Beach
<br /> O ' •.. 18070 Collins Avenue
<br /> Sunny Isles Beach,FL 33160
<br /> ® c'''or 3Vµ'"C' Telephone:(305)947-0606 Fax:(305)949-3113
<br /> ® STATE OF FLORIDA )
<br /> ® )
<br /> COUNTY OF I—�cJ,P )
<br /> ® The undersigned being first duly sworn as provided by law,deposes,and says:
<br /> 0 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 /> O The undersigned is authorized to make this Affidavit on behalf of,
<br /> ® Ma ,u Sc.cr, 141,n., r a.2, I s ° OS 19
<br /> • (Name of Corporation,Partnership,Individ I,eta'
<br /> a, 5 ("Al i c'kS ,formed under the laws of F L
<br /> ® (Type of Business) (State)
<br /> ® of which he is ecer1 C4 .
<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 /> O 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 /> ® _ -c i re
<br /> ® AFFIANTS Nr^'~�- AFFIANT'S TITLE
<br /> ® TAKEN,SWORN AND SUB CRIBED TO BEFORE ME this day of , GLYew^ e S ,201R
<br /> ® /�Personally Known or Produced Identification ,
<br /> ® Type of identification ///
<br /> ® (Affix seal here) • //2 /In
<br /> 0 •
<br /> NOTARY P =LIC(name printed or typed)'
<br /> ® d. Rvn q
<br /> �• �B% PASCAL sit
<br /> ® =r)•—NA: Notary Public-State of Florida
<br /> %,-, -0....,....,,4,
<br /> • c': •P Commission #FF 191856
<br /> ,��0�,a,,• My Comm. Expires Jan 25,2019
<br /> •""'' Bonded through National Notary Assn.
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