|
hVtrlte•® p, _6 I NON - COLLUSION AFFIDAVIT
<br /> J City of Sunny Isles Beach
<br /> 18070 Collins Avenue
<br /> �.• o'• Sunny Isles Beach,FL 33160
<br /> o •
<br /> c"P or sv.• Telephone:(305)947-0606 Far(305)9433113
<br /> Ake
<br /> STATE OF PtOR}BA )
<br /> COUNTY OF 1rn9ell )
<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 /> M1600414-1on) ,4nf'u617c P/4°D✓CC,i,Jc , •
<br /> (Name of Corporation,Partnership,Individual,etc.) 1 I
<br /> a, S-Oki) ,formed under the laws of IV`-
<br /> (Typpee of Business) (State)
<br /> of which he iss I 0 6-11—
<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 fa 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 /> AFFIANT A E AFFIANT'S TITLE ��11 n�1 '
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 10 day of / ,20
<br /> Personally Known ✓ - or Produced Identification
<br /> Type of identification
<br /> 010110 uu,(A1Ta seal here) ')),L0 Go R rr Q 41�
<br /> ^ ntr
<br /> dN RY PUBBUC(name printed or type
<br /> +01 OP-
<br /> 7 �U BOG V
<br /> `MmirnnOLOCk
<br /> DECEMBER 28,2010 1 of 10
<br />
|