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II S,)NNY lE,
<br /> BS/-ir.-r 1 e
<br /> I 0, 0 NON - COLLUSION AFFIDAVIT
<br /> .; City of Sunny Isles Beach
<br /> �� " 18070 Collins Avenue
<br /> 1..�'.- •o soQ• Sunny Isles Beach,FL 33160
<br /> a 'o. sus '� Telephone:(305)947-0606 Fax:(305)949-3113
<br /> NEW YORK
<br /> STATE OF MEE )
<br /> ONONDAGA )
<br /> COUNTY OF )
<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 /> IIThe undersigned is authorized to make this Affidavit on behalf of,
<br /> Ballard Construction, Inc.
<br /> (Name of Corporation,Partnership,Individual,etc.)
<br /> a, S-Corporation ,formed under the laws of New York
<br /> (Type of Business) (State)
<br /> of which he is Vice-President
<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 /> I to any member or agent thereof.
<br /> 1 Y, {D
<br /> I. /"/
<br /> Vice-President
<br /> UAFFIANT'S A M AFFIANT'S TITLE
<br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this j day of Der ,20ya
<br /> IPersonally Known I/ or Produced Identification •
<br /> Type of identification /�/
<br /> (Affix seal here) U� E (.N/1 //
<br /> 6 VALORIE T.WOOLLEY NOTARY PUBLIC(name printed or typed)/
<br /> Notary Public in the State d New York {�AL02/� (a WUU LLG y
<br /> Quatilied in Cayuga County No.4670472
<br /> My Commission Expires Wirth 30,/
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<br /> O
<br /> aDECEMBER 28,2010 1 of 10
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