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Southeastern - City of Sunny Islse RTQ 22-12-01 Signed Forms
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Southeastern - City of Sunny Islse RTQ 22-12-01 Signed Forms
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C,} of SUO Ptk4 <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 />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:i7zzl— <br />I <br />Title: UkTgU LLL�2 <br />The foregoing instrument was acknowledged before me this (O day of <br />aN O WY 20 23 , by kcher"t Cai-�A-hcn [name <br />of person], as ( C",rr, acv- [type of authority], for <br />�s4-,) Pr,, -) -ft r,ci Co.,T'r)(., [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />,jW Rodger A. Heckman <br />o� Notary Public <br />=State of Florida <br />`? Commp HH066017 <br />r'NCE I Expires 11/22/2024 <br />Al . <br />4a <br />Notary Public — State of Florida <br />RC)dger Aa Hec l�--Irnctn <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />7of8 <br />
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