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:i 1Q: P <br />• O• .JM <br />STATE OF FLORIDA ) <br />COUNTY OF Broward ) <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />18070 Colfins 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: Patrick J. Gibney, P.E. <br />Title: i President Engineering <br />The foregoing instrument was acknowledged before me this 12th day of <br />August , 20 14 , by Patrick J. Gibney, P.E. [name <br />of person], as Vice President, Engineering [type of authority], for <br />Craven Thompson & Associates, Inc. [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP,JN 01 <br />= 1. �'� �oh232pFto.• <br />Ndt ry Public to of Florida <br />_ �•• _ <br />tFKACIA D. JOyGIF, <br />Print or Type Commissioned Name <br />'`/ nuunH�a <br />Personally Known V OR Produced Identification <br />Type of Identification Produced <br />DECEYME 25. 2010 7 of 7 <br />6 1 Page 13 <br />