HomeMy WebLinkAboutexhibit1D2ATTACHMENT D2
Attachment D2
MIAMI-DADE COUNTY DEBARMENT DISCLOSURE AFFIDAVIT
(Ordinance 93-129, Section 1)
I, being duly first sworn, upon oath deposes and says that the bidder of this
contract or his agents, officers, principals, stockholders, subcontractors or their
affiliates are not debarred by Miami -Dade County.
By:
(Signature of Affiant) (Date)
SUBSCRIBED AND SWORN TO (or affirmed) before me this day of
200_ by
is personally known to me or has presented
as identification.
. He/She
(Signature of Notary)
(Print or Stamp of Notary)
Notary Public — Stamp State of (State)
(Type of Identification)
(Serial Number)
(Expiration Date)
Notary Seal
5/01