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STATE OF FLORIDA ) <br />COUNTY OF $_WaA ) <br />ANTI -KICKBACK <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br />Telephone: (305) 947-0606 Fax: (305) 949-3113 <br />ANTI -KICKBACK AFFIDAVIT <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br />will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a <br />commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or <br />by an officer of the corporation. <br />By: <br />n <br />Title: UICC_ \rC'SI�P11 <br />The foregoing instrument was acknowledged before me this -3v"r day of <br />5,,k�,Y 20 aq , by SASoN .HSTF C—d- �TtE [name <br />of person], as y cry I j_ -(1Z'+ [type of authority], for <br />0 5 bitch Lntic; [name of party on behalf of instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />•�;rPv",,, RYAN D. ZSIGA <br />Commission # GG 022064 <br />:oc Expires August 16, 2020 <br />z'•� ,�t� i °"' Bonded Thru Troy Fain Insurance M385.7019 <br />Notary Publiy.' At$td of Florida <br />12Yr N Zs s &A <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification i< <br />Type of Identification Produced 'VL. WIC -z"39 <br />RFQ 20-07-01 CONTINUING PROFESSIONAL CONSULTING SERVICES <br />SECTION H - PAGE 73 <br />