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o. <br />ryr Crrr Or {UO ~O,` <br />STATE OF FLORIDA ) <br />COUNTY OF Miami -Dade) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br />Telephone: (305) 967 -0606 Fax: (305) 94 9-3113 <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: Randy Hollingwoitth <br />Title: Vice President <br />The foregoing instrument was acknowledged before me this day of <br />CN 01U5'1y 20 \1--t , by (Q)oLL:L4 [name <br />of person], as V r-e 0(e3'a [type of authority], for <br />cmLC \o Fk�a:r \C �c(cS.1sn� [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />A'"� �E� Notary Public — State'of Florida <br />Y. { NY COWLS" t BE 114MO <br />3 .• EXPIRES! July 21, 2015 1 <br />`eaaeaThunovrPDACUneeMEns Aor)A(0,, l7cncAc ) <br />Print or Type Commissioned Name <br />Personally Known 1n OR Produced Identification <br />Type of Identification Produced <br />131 <br />DECEMBER 28, 2010 7 of 7 <br />