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yr <br /> low <br /> lor <br /> 400 SJNNY'S�Ft <br /> i°�r <br /> "'�` �l�r `z ANTI — KICKBACK <br /> lir <br /> , f; City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> ''',,::*--c, <br /> P ,t Sunny Isles Beach,FL 33160 <br /> lir <br /> c'''0,sui.'~'' Telephone:(305)947-0606 Fax (305)949-3113 <br /> r ANTI-KICKBACK AFFIDAVIT <br /> iiir <br /> STATE OF FLORIDA ) <br /> Air COUNTY OF ) <br /> VW I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br /> 'e" will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a <br /> it 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 /> oir <br /> / c1t c . - al'/5 AZ,/,7_, <br /> Ir► By' 07 <br /> Ir4 <br /> Title: -reCi d akki <br /> fir► <br /> tor J he foregoing instrument was Acknowledged, before me this (Z day of <br /> lir 1' r6A,k , 20 ( , by C41/v 5 ,L7(,�?"� [name <br /> ir► of person a (PPPS(der e [type of authority], for <br /> r �u ri':- ( ,i 1 Cf ra te'1, .4n e---- [name of/pay on behalf of , • , .,, s -ti 7,:k,Ez <br /> iiir ] "• Notary Public—State of Florida <br /> executed]. /� Commission#GG 159830 <br /> P <br /> • <br /> 022 <br /> ,, Bonded through Sonar Notary, My Comm Expires Mar 4,2Assn <br /> iir AFFIX NOTARY STAMP HERE:iiir �``� 9 <br /> IV 01914•ubIi , at Florida <br /> 4 Id 701 Aka <br /> 411, Print or Type Commissioned Name <br /> Iii. <br /> '' CersonallKn� ow OR Produced Identification <br /> ifir Type of Identifica ion Produced <br /> isp <br /> iiar <br /> o <br /> Ir <br /> *II. <br /> DECEMBER 28 2010 7 of 8 <br /> lily <br /> lir <br /> iiiir <br />