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Cordova Rodriguez & Assoc., Inc.
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(14-07-02) Continuing Professional Architectural and Engineering Services - Individulas Only CCNA
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Cordova Rodriguez & Assoc., Inc.
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Last modified
1/7/2015 11:31:14 AM
Creation date
8/22/2014 4:21:19 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Continuing Professional Architectural
Bid No. (xx-xx-xx)
14-07-02
Project Type (Bid, RFP, RFQ)
RFQ
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`,VNMT II(F <br />0. <br />n <br />V � Z <br />o <br />STATE OF FLORIDA ) <br />COUNTY OF Broward ) <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: Luis E. Rodriguez, P.E. <br />Title: Principal <br />The foregoing instrument was acknowledged before me this 5 day of <br />It�� Si 2014 , by Luis Roc(r z- [name <br />of person], as DI- (h(,i► n ( [type of authority], for <br />Cc) rdoya Rcrl -,4A z RSsccla [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Y/ /2 � a A <br />1 <br />REGINA pICpOLGLAUgSR Public — o lorida <br />NOTARY PUBLIC <br />STATE OF FLORIDA ,111 19 <br />Comm# EE088693 7-6 <br />Expires 5/6/2015 rint or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 2B, 2010 7 Of 7 <br />
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