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RFP No. 19-12-01 Printing and Mailing Services
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Colonial
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1/31/2020 11:38:07 AM
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SUNNY s1.BJ <br /> °4 � °, ANTI - KICKBACK <br />' 0 ,4..:_...7 <br /> 0 ` "° City of Sunny Isles Beach <br /> -! --.- • 18070 Collins Avenue <br /> tie, 9,�,�Fiov. 1/2,: Isles Beach,FL 33160 <br /> '''.'.or suµ.'ac Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF Miami-Dade ) <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: Chris Seruga r ' . <br /> Title: Chief Operating Officer <br /> 0 The foregoing instrument was acknowledged before me this 31st day of <br /> December , 20_19_, by Chris Seruga [name <br /> of person], as Chief Operating Officer [type of authority], for <br /> Colonial Press International [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: l � '``� <br /> ,^ ROSA RODRIGUEZ 0 <br /> o ry Pu ' — Stateof FIG a <br /> i 'i4'441. f'. Notary Public-State or Florida � r <br /> '1" ; "d Commissior=GG 347773-'.�'o7'r' '` My Comm.Expires Apr 5.2023 O S G, koD (z/ u e 2.- <br /> 1 <br /> 1 Bonded throcgh National Notary Assr. ( Print or Type Commissioned Name <br /> Personally Known X OR Produced Identification <br /> Type of Identification Produced 1 <br /> 0 <br /> DECEMBER 28,2010 <br />
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