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.,, <br /> .,. <br /> Q ss3,...,,,.„,, <br /> —,„ <br /> ,�/ � ANTI-KICKBACK <br /> :ii i, <br /> tidy :\ • City of Sunny Isles Beach <br /> - 18070 Collins Avenue <br /> itir !� '•r,o•goo*is Sunny Isles Beath,FL 33160 <br /> ''o„u.'" Telephone:(305)947-0606 Fax:(305)949-3113 <br /> Ilit, <br /> 400 ANTI-KICKBACK AFFIDAVIT <br /> b <br /> tir <br /> STATE OF FLORIDA ) <br /> It* COUNTY OF ) <br /> I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br /> it" will be paid to any employees of the City of Sunny Isles Beach or its electedofficials as a <br /> 1, 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 /> to By. o-r <br /> - ar/05 ��lutie�. <br /> Title: .1feSlcfzrf d <br /> iiir <br /> 0 <br /> l e foregoing instrument was cknowledge before me this (2 day of <br /> �1 G�`U tor <br /> , 20 l� , by C:4(10 5 �(�u,-7"2- [name <br /> ii. of. person f i <br /> a eSIdPrte. [type of authority], for <br /> c i\(civlt (�,II1Strac• leti, n"-- [name of/party on behalf of ' . . • • ;v. .wrk• <br /> �, executed]. / _� ,;"'P---,'°�; Nagy puac-s►�ofFlorida <br /> Commission#GG 159830 <br /> ,.= My Comm.Expires Mar 4,2022 <br /> AFFIX NOTARY STAMP HERE: ;- aA...., NajOBal <br /> A. o• •ubliFlorida <br /> k <br /> I IS • Am ..4; <br /> i' r Print or Type Commissioned Name <br /> OP <br /> iir Personally Kr— o OR Produced Identification <br /> iir Type of Identification Produced <br /> fir► • <br /> fiF, <br /> tor <br /> r�I <br /> `Y' <br /> DECEMBER 28,2010 7 of 8 <br />