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Ot 5uS <br />A NTI-KICKBACK <br />City of Sunny lsles Beach <br />18070 Collins Avenue <br />Sunny lsles Beach, FL 33160 <br />Telephone: (305) 947-0606 Fax: (305) 949-31 .1 3 <br />ANTI.KICKBACK AFFIDAVIT <br />STATE OF FLORIDA <br />COUNTY Qf $rovot".?v <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 />(- <br />J"^,, ua'ttc. L tl-'-- <br />Title: VP of aa)es <br />The foregoing instrument was acknowledged before me this t day of <br />by Iname, for[type of authority] <br />of pafi on behalf of whom instrument was <br />executedl <br />AFFIX NOTARY STAMP HERE <br />of Florida <br />6;sL par tec* ilAzf <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />) <br />) <br />) <br />ASof <br />SIBI NA}TEELA HACK <br />Notrry Public . St.te of Florld! <br />Commirelon # HH 20852 <br />f,y Comm. Erpir* Oct 4, 2024 <br />Bonded through Nation6l Xotary Asrn, <br />7 ol8