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Clean Space, Inc.
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(19-08-02) Janitorial Maintenance Services
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Clean Space, Inc.
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Last modified
9/30/2019 2:52:28 PM
Creation date
9/30/2019 11:39:47 AM
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CityClerk-Bids_RFP_RFQ
Project Name
Janitorial Maintenance Services
Bid No. (xx-xx-xx)
19-08-02
Project Type (Bid, RFP, RFQ)
Bid
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O� S,NNr is, <br />U x <br />•, Or <br />FLO" <br />t Cir` O <br />O, S't4' <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 />Matt Giunco <br />Title: Operations Manager <br />The foregoing instr pent was acknowledged before me this 23 day of <br />20 byy%AQ 1d— Cq I $ nC-> [name <br />of person], as MCA [type of authority], for <br />[name of party on behalf of whom instrument was <br />executed]. <br />AFFD( NOTARY STAMP HERE: <br />Say-ldyci P . A3r30 C'.. <br />�� • • Notary PubliC — State of Florida <br />COMMISSION # GG2278533 <br />CC: Z Z) g S 3 <br />• ix .• = EXPIRES: June 12, 2022 Print or Type Commissioned Name <br />Bonded Thru Aaron Notnry <br />Personally Known OR Produced Identification fiucur L�ca„c . <br />Type of Identification Produced 10TR L14 C1 I <br />DECEMBER 28, 2010 7 Of 8 <br />
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