Laserfiche WebLink
STATE OF FLORIDA <br />COUNTY OF M OM <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 />The foregoing <br />IUy , <br />of person], as _ <br />executed]. <br />B 1�"(-G <br />Y• <br />Title: 91'aSIL� C.(I <br />instrument was acknowledged before me this day of <br />20 Z ? by 6X U 'n,-6) [name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br />AFFIX NOTARY STAMP HERE: <br />ELIZABETH PAGE <br />Notary Public State of Florida <br />Commission # HH 24670 <br />My Comm. Expires Mar 29, 2025 <br />Bonded through National votary ass. . <br />Notary Public — State of Florida <br />Print or Type Commissioned Name <br />Personally Known // OR Produced Identification <br />Type of Identification Produced i. ) / 1� <br />DECEMBER 26, 2010 <br />