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.SUNNY !S�@ <br />� n <br />u � x <br />S, „ �, <br />yF y9x ",.f LOT' 4 <br />of sun <br />STATE OF FLORIDA COUNTY OFW69)) <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 />� <br />The foregoing <br />i <br />of Dersonl. as J <br />executed]. <br />B -- <br />Y• <br />Title: ® �c <br />instrument wa acknowledged before me this day of <br />ZOO, by ---4�xA 2 am FIZEL- nou [name <br />)yTir+u Poi3 iz [type of authority], for <br />tiS6E- [name of party on behalf of whom instrument was <br />AFFIX NOTARY STAMP HERE: <br />ill�laarr <br />stee.dF*W <br />S►eawaonnoe <br />a Cammi�eton Noy t�0 ptOt87 <br />C�_ F_'4 <br />Notary Pu li — State of Florida <br />&L"!)ago J:2 E_ a&v <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification Ll� <br />Type of Identification Produced q,,0Qjing U i C -OS <br />DECEWER 28, 2070 <br />