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SF '/`F- o?� l r <br />v <br />STATE OF FLORIDA <br />COUNTY OF <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 />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: <br />T foregoing instrument was acknowledged before me <br />of person], as�z���� [type <br />[name of party on behalf of <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />o<�r P�`BL'• LUIS R, JIMENf:Z <br />=lam ,�• Notary Public • State of Florida <br />:� 4 Commission GG 286860 <br />v? or r�°' My Comm, Expires Apr 21, 2023 <br />Bonded through National Notary Assn* <br />this <br />of <br />whom <br />�. day of <br />_ [name <br />authority], for <br />instrument was <br />Print or Type Commissioned Name <br />Personally Known �� OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 <br />