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00.4NY islet <br /> NON - COLLUSION AFFIDAVIT <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> ' AD''•Fo ' '� Sunny Isles Beach,FL 33160 <br /> ''OF :uµ'H Telephone:(305)947-0606 Fax:(305)949-3113 <br /> STATE OF F261i <br /> ) <br /> COUNTY OF Cc////�Q fir) <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 RFP. <br /> The undersigned is authorized to make this Affidavit on behalf of, <br /> nnppriSes / lilC <br /> (Name of Corporation,Partnership Individual,etc.) <br /> a, (1 Dl Ot - ,formed under the laws of / !V <br /> (Type of Busiinne'ss) (State) <br /> of which he is ��LC�vI l tBuil • <br /> (Sole Owner,Partner,President,etc.) <br /> Neither the undersigned nor any person, firm, or corporation named above nor anyone else to the knowledge of the undersigned, have <br /> 410 themselves solicited or employed anyone else to solicit favorable action for this RFP by the City, also that no head of any department <br /> or employee therein,or any officer of the City of Sunny Isles Beach, Florida is directly interested therein. <br /> This RFP is genuine and not collusive or a sham; the person, firm or corporation named above has not colluded, conspired, connived or <br /> agreed directly.or-indirectly with any proposers or person; firm or corporation, to put.in a sham.RFP, 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 <br /> contained in the RFP or RFP's described above true; and further, neither the undersigned, nor the person, firm or corporation named <br /> above has directly or indirectly submitted said RFP or the contents thereof, or divulged information or data relative thereto, to any <br /> association or to any member or agent thereof. <br /> 4C— CEO <br /> AFFIANTS NAME AFFIANTS TITLE <br /> TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME thisill day of /hatl ,2018. <br /> Personally Known V or Produced Identification • <br /> Type of identification <br /> (Affix seal here) <br /> NOT Q =UC(n. e printed or type• <br /> "� TIFFANY MIXES <br /> mX. My Notary ID#123933814 <br /> :' ,o '••'F Expires January 27,2022 <br /> _•.0 ♦ I' 4 _ A— <br /> O <br /> 1 of 10 <br />