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STATE OF FLORIDA ) <br />_" �`Orm ) <br />COUNTY OF -04 i ) <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 />i <br />Title: W I cc Pres <br />The foregoing instrument was ackno ledged before me this day of �o 1101 L4 <br />202J by fil m/' r7lrl�411 _ [name <br />of pers n], as [type of authority], for <br />�1s/�cidivi �,�'/�'7 i11��✓�i��✓��r 6� .l(� (name of Dartv on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY_ STAMP HFal- <br />Notary Public State of Florida <br />A John Peter Beadel <br />MyHH 236473 on <br />1111 EXp.512112026 <br />6. <br />lic — State of Florida <br />/ & i 6,60,1a. <br />Print or Type Commissioned Name <br />Personally Knowp _ OR Produced Identification <br />- Type o Identification Produced P I. A <br />7of8 <br />