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The Stout Group, LLC
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(23-02-01) East End of 172nd St Rdway & Drainage Improvements
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The Stout Group, LLC
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Last modified
4/4/2023 11:16:55 AM
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4/4/2023 11:12:54 AM
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STATE OF FLORIDA ) <br />COUNTY OF Wi xm i=Da04,) <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: <br />Title: lq0q <br />The foregoing instrument was acknowledged before me this �ZS day of <br />a rm , 202;1--, by 10_Se_ tQd& nt.ln ter [name <br />of person], as ai) r [type of authority], for <br />,-Q, S +rjL;pL L , L4_ - _ [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />+ pu`•. YVETTE ZULUAGA <br />iQ • Notary Public <br />State of f lorida <br />=� Commission 9 HH 245674 <br />fl My Comm. Expires Jan 7, 2026 <br />Bonded through National Notary Assn. <br />Notary r is — Sfa a of Florida <br />I A <br />Print or Type Commis toned Name <br />Personally Known X OR Produced Identification <br />Type of Identification Produced n <br />DECEMBER 28, 2010 <br />
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