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