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<br /> �F NON - COLLUSION AFFIDAVIT
<br /> ` / City of Sunny Isles Beach
<br /> }•• •
<br /> - /r'•' 18070 Collins Avenue
<br /> y�\, •FLO%N Q,•. Sunny IslesBeach,FL 33160
<br /> I-of sus' Telephone:(305)947-0606 Fax:(305)949-3113
<br /> STATE OF FLORIDA
<br /> COUNTY OF M1aK ' '9
<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 /> �olPKW) 1Ovvtr' HD. Inc
<br /> (Name of Corporation,Partner ,Individual,etc.)
<br /> a, –Tow i n ,formed under the laws of FL
<br /> (Type of Busing) (State)
<br /> of which he is OW rl•C Y
<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 /> 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 /> Denise I. lodarse Owner
<br /> AFFIANT'S NAME AFFIANT'S TITLE
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 5 day of Dec er i bet— ,2017
<br /> Personally Known or Produced Identification ✓ ,
<br /> Type of identification I y ve- c L t C-ev1St
<br /> (Affix seal here) (x, it
<br /> NOTARY PUBLIC(name printed or typed)
<br /> • 1. CASTRO !' 41nu::N COLE CASTRO
<br /> ® #FF 979387 `* Commission#FF 978387
<br /> =* ` .- =sion Expires ,ir�? My Commission Expires
<br /> '-'+�tilo«;:' 06, 2020 "%',;ean °\` April 06, 2020
<br /> ,,Alli,\l\s IIP11\
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