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OP SJ NNY 1J4ES9 <br />P <br />/y V'. FLOP <br />°jrr °r $0 <br />STATE OF FLORIDA <br />• • i_luiP <br />NTl- 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 />or person, as <br />f�DY11 Cbl Vv Gin�tSt <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />�� � Notary Publw State of Flofloa <br />MGina Marie Geiler <br />a My Commission GG 228717 <br />a Ezpves 10/05/2022 <br />Personally Known i� OR <br />Type of Identification Produced . <br />DECEMBER 20, 2010 <br />Title: Director of Sales <br />s acknowledged before me this 19 day of <br />[name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br />I/ <br />Nota Plibblic —State of Florida <br />& V N MUk% , CAW <br />Print or Type Commissioned Name <br />Produced Identification <br />