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STATE OF FLORIDA ) <br />COUNTY OF Bi''oWeJ ) <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: n <br />Title: o I(_e 1 rCS ic�Pt� <br />The foregoing instrument was acknowledged before me this 01 day of <br />,,,4..Y , 20 'ao , by —75-A sO N JAST IES t"MIZE [name <br />of person]as V .14L P^vs l All, -.t [type of authority], for <br />05b4trvl L''ulrhu�N [name of party on behalf ofr instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />•;;+Pyr• RYAN D. ZSIGA <br />AA, <br />Commission # GG 022064 <br />:o; Expires August 16, 2020 <br />"'� Bonded Thru Troy Fain Insurance 800385.1019 <br />Notary Publig(—,t#tX of Florida <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced IVL_ ,,,vis a•CENSE <br />RFQ 20-07-01 CONTINUING PROFESSIONAL CONSULTING SERVICES <br />SECTION H - PAGE 73 <br />