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4V p1NY lg��. <br />O d <br />V � <br />k <br />F <br />C�rY OF SU14 FNO <br />STATE OF FLORIDA ) <br />COUNTY OF 4 <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 />Title: <br />l4 -6z <br />►95:--0c" <br />The foregoing instrument was pcknowledged before me this day of <br />20 2U , by, L 1/6 a , 04 64 [name <br />of person], as I Q 9-- a)1— [type of authority], for <br />IT,4 1 k.�a_e AWVLf_ [name of party on behalf of whom instrument was <br />executedj_- <br />AFFIX NOTARY STA �a . Perez Aya a Florida <br />✓� Exp es 023 924496 <br />1012112tary Public — State of Florida <br />A, A, <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER28,2010 7 Of 8 <br />