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PINCREST 16 001Non - Collusion Affidavit Pinecrest Villas Neighborhood Traffic Calming Phase 11 STATE OF FLORIDA COUNTY OF MIAMI -DADE 6pb6 AWA tS"Tin9 -,L -?�'i '.I�1 being first duly sworn, deposes and states that: (1) He /She/They is /are the ? "t (Owner, Partner, Officer, Representative or Agent) Of '1 6YX ' P1101i la Qc lc /1C.the BIDDER that has submitted the attached BID; (2) He /She/They is /are fully informed with respect to the preparation and contents of the attached BID and of all pertinent circumstances concerning such BID; (3) Such BID is genuine and is not a collusive or sham BID; (4) Neither the said BIDDER nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or indirectly, with any other BIDDER, firm, or person to submit a collusive or sham BID in connection with the Work for which the attached BID has been submitted; or to refrain from bidding or proposing in connection with such Work-, or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or conference with any BIDDER, firm, or person to fix any overhead, profit, or cost elements of the BID or of any other BIDDER, or to fix any overhead, profit, or cost elements of the BID Price or the BID Price of any other BIDDER, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Work; (5) The price or prices quoted in the attached BID are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the ,part of the BIDDER or any other of its agents, representatives, owners, employees *pa of, interest, including this affianr Signed, sealed & delivered in the presence of: BT wV Si nature Ztk Print Name land Title Subscribed and sworn to before me this --�— day of I �,' :� _ , 20 20 Y PL `s I FRiCIA FLANLfv z Ely.- s = Notary Public -state of Florida Notary Public (Signature) ��11 <_ my comm. Expires Feb 27, 2018 My Commission Expires: , d Q. Commission r EE 173810 j FAILURE TO COMPLETE. SIGN, & RETURN FORM MAY DISQUALIFY YOUR RESPONSE © thomasfpepe- 09 -28 -1 1 (Updated 05 -16 -2012) Page 21