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O� SJNNY'SC�fB <br />A F <br />n <br />v x <br />S, C,' • F -L O a,a •fit <br />Cil} Or Sul, *HO <br />STATE OF FLORIDA <br />COUNTY OF Miami Dade <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 />Title: Sr Vice President <br />The foregoing instrument was acknowledged before me this a17 day of <br />coep�C06cr— , 20 A O , by Cln&ele.s [name <br />of person],. as Sr. pnUi-Sr--if [type of . authority], for <br />[name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />ANTHONY ROBERT NAPOLEON <br />J L Notary Public -State of Florida <br />Commission # GG <br />•t My Commission Expires <br />�� r� "�• Fe4uary 25. 2023 <br />Personally Known <br />Type of Identification Produced <br />Notary Public — State of Florida <br />Print or Type C mmissioned Name <br />OR Produced Identification <br />DECEMBER 28 2010 7 of 8 <br />