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utaNY ?5, <br />n <br />sy __.lor r <br />'`r Cr �• FLOp o.a <br />Ty of SUN <br />STATE OF FLORIDA ) <br />} <br />COUNTY OF "(i 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 />IN <br />/V EC1-,lel 1C � 1 �N C1� <br />Title: p� i SNI <br />The foregoing instrument was acknowledged before me this �2 day of <br />'I Aa\_4 20 - , by[name <br />of person], as e c '51 �Ve�L\� <br />�C� <br />[type of authority], for <br />Tr[name of party on behalf of whom instrument was <br />execute . ge&6VP'N' INo- <br />AFFIX NOTARY STAMP HERE: <br />RNoiary pubic Sten of Florida <br />Aanana Rijn,My C"mm� ;an HH 005456 <br />f: xpC1res 05'3 +:2724 <br />©/aI/,,;, C_-;� �x4 <br />Notary uP blic — State of Florida <br />_Jmylonn C?tj'() <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced Y"kk 3 UconSC-v <br />7of8 <br />Ri::;P k 2-3 - 65--d1 <br />