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STATE OF FLORIDA ) <br />COUNTY OF W\W,Vkt ) <br />ANTI -KICKBACK. <br />City of Sunny Isles Beach <br />18070 Collis Avenue <br />Sunny Isles Beach FL 33160 <br />Telephone: (305) 947-0606 Fax (305) 949-31 13 <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: Wl� T-up6 `- <br />Title: CF 0 0,K4 PQ E61 A k t\j 7— <br />The foregoing instrument was acknowled ed before me this day of <br />;PCI <br />, 20�, by C [name <br />operson], s [type of authority], for <br />� 1 D [name of party on behalf of whom instrument was <br />eted]. i z- \tiv, Q <br />AFFIX NOTARY STAMP HERE: <br />Personally Known <br />Type of Identification Produced <br />Notary Public — St5i67 of Florida <br />Print or Type Commisi ned Name <br />OR Produced Identification <br />7of8 <br />RETDtA <br />Notary PubliridaCommissi0My <br />Favided <br />Comm. E2023 <br />through NAssr. <br />Personally Known <br />Type of Identification Produced <br />Notary Public — St5i67 of Florida <br />Print or Type Commisi ned Name <br />OR Produced Identification <br />7of8 <br />