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pt x%'4+1 f f <br />O� fV�• <br />STATE OF FLORIDA ) <br />COUNTY OF Broward ) <br />ANTI- KICKBACK <br />City of Sunny Isles Beach <br />16070 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br />Telephone: (305) 947 -0606 Fax: f305) 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 instrument <br />2C fit- by <br />�rso❑ . as <,lA Q <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />°4,e'.. DAWN HOPKINS <br />•'� `• Notary Public State of Florida <br />�P• My Comm. Expires Feb 18. 2017 <br />Commission a EE 84709] <br />By: Dennis J.Giordano <br />Title: President <br />acknowledged before me this day of <br />P Yy115 &C)r� VAn [name <br />[type of authority], for <br />[name of party on behalf of whom instrument was <br />Notary Public — State of Florida <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 7 of 7 <br />