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<br /> ® 6 NON - COLLUSION AFFIDAVIT
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<br /> \ r: City of Sunny Isles Beach
<br /> 18070 Collins Avenue
<br /> *. .'•f Eo00:•• Sunny Isles Beach,FL 33160
<br /> c. or raw.. Telephone:(305)947-0606 Fax:(305)949-3113
<br /> STATE OF FL R41T (.S
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<br /> COUNTY OF I 1 )
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<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 tiled 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 /> lief IX cOnsfttL r` tic.
<br /> (Name of Corporation,,Paalrt/neership,Individual, lc.) ���•
<br /> a,a%il ��\ll 1 ,formed under the laws 0116
<br /> 1/�')��(T/r'�.�o-ff�Business) yI (S ate)
<br /> of which he is (O1 ►D ate. �f v
<br /> (Sole Owner,Partner,Presi ent,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 /> • -ny member or agent thereof.
<br /> �li ►, .... /1 .:,1 ' ,S3',t'�f r2•• ' NAME �// AFFI T'S TITLE
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<br /> TAKEN,SWO(2NQ.ND SUBSCRIBED TO BEFORE ME this I I day ofl��wr a l ' 20��
<br /> Personally �r/ �, I or Produced Identification
<br /> Type of identification 1�/[P I
<br /> (Affix seal here)
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<br /> ,pt` December NOT• • r�nam. • typed)
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<br /> OECES®ER mane 1 of 10
<br /> Hellas Construction,Inc. RFP#12-10-03 P.98
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