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STATE OF FLORIDA <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 />county of ??ro\Nard ) <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:.^ob-trph dcX\or <br />J <br />Title:PCjSbnf.r <br />The foregoing instrument was acknowledged before me this <br />fcbai^.rvv 20 \°\.by "3&W <br />c3b day of <br />[name <br />YCufirntAofperson],as [type of authority],for <br />QC££M5^PQlVl^Mm^A LLP [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />SJSSS <br />4H%-DEBBIE WALSH <br />?.:A u%MY COMMISSION *FF 9353* <br />W?W EXPIRES:November 11,2019 * <br />'''t'f&ffi*Bonded Thru Nota/y Public U^emmters <br />WUIa*MMI<MJ Notary Public -State of Florida <br />"to/3/1 UkiXi^. <br />Print or Type Commissioned Name <br />Personally Known <br />Type of Identification Produced <br />DECEMBER 28,2010 <br />OR Produced Identification <br />44