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0t S,N14r ,f,Ffe <br />+� n <br />V � Z <br />It <br />SIC „'� <br />STATE OF FLORIDA ) <br />COUNTY OF Broward ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach. FL 33160 <br />Telephone (305) 947 -0606 Fax: (305) 949 -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. <br />By: <br />Rene L� <br />Title: President <br />The foregoing instrument was acknowledged before me this 4 day of <br />September 20 13 , by Rene L. Castillo [name <br />of person], as President [type of authority], for <br />Ric -Man International, Inc. [name of party on behalf of whom instrument was <br />executed]. <br />1 AFFIX NOTARY STAMP HERE: <br />It <br />1 <br />L <br />Notary Public — State of Florida <br />Marcia West <br />Print or Type Commissioned Name <br />Personally Known X OR Produced Identification <br />Type of Identification Produced <br />DECEMBEa 23, 2010 7 of 7 95 <br />;'s,•” <br />' :2 <br />..:NEST <br />-.:nhc - :ate of Florida - <br />•. r: <br />,",,, <br />.. <br />a; .c'.::. EeDR =s May 9 5 3 <br />Co � ,;smn a EE 90593 <br />It <br />1 <br />L <br />Notary Public — State of Florida <br />Marcia West <br />Print or Type Commissioned Name <br />Personally Known X OR Produced Identification <br />Type of Identification Produced <br />DECEMBEa 23, 2010 7 of 7 95 <br />