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(13-08-01) Design build svcs for Gateway Park Pedestrian bridge- STEP 1
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Last modified
9/15/2013 5:57:38 PM
Creation date
9/5/2013 4:49:21 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Design build svcs for Gateway Park Pedestrian bridge- STEP 1
Bid No. (xx-xx-xx)
13-08-01
Project Type (Bid, RFP, RFQ)
RFQ
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VI SVM <br />STATE OF FLORIDA ) <br />COUNTY OF Miami -Dade ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />16070 CoMns Avenue <br />St y Isl4s Beach, FL 33160 <br />Telephone: (305) 947-0606 Faz (305) 94 9-3113 <br />ANTI- KICKBACK AFFIDAVIT <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br />will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a <br />commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or <br />by an officer of the corporation. 1/1i7 <br />The foregoing instrument <br />® i 20� by <br />I fInper i ,%1�uc�> -) <br />executed]. <br />n <br />LJ <br />AFFIX NOTARY STAMP HERE: <br />R Notary Pudic State W Flonaa Maria Melia My Cornrnlsafon EE 210945 <br />Expires 0624(1016 <br />0 <br />Title: <br />mdez, President <br />Was acknowledged before me this day of <br />1/,1 dIrrmo OrnGnd[Z [name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br />No ary Public — State of Florida <br />MririG <br />Print or Type Commissioned Name <br />Personally Known X OR Produced Identification <br />Type of Identification Produced <br />NcO 29.XIO <br />7 of <br />
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