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STATE OF FLORIDA ) <br />COUNTY OF l7Q ) <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: <br />Title: / f'i 5/ (3 °e'1 v <br />The foregoing instrument was acknowledged before me this $� day of <br />Deze !,e�r , 20�Z3, by Mom bc�rdo Or-d-r'Z [name <br />of person], as Pre�St� f[type of authority], for <br />AOM C0n.S4-CUCd,'oo,.T7riG [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Nolary Publlo Stete of Fiorlda <br />d L11Allyson Ibanez <br />11 My Commission HH 419795 <br />Expires 6/22/2027 <br />Nota�State of FloWda <br />�lllYs on 7/I� ar, e -Z <br />Print or Type Commissioned Name <br />Personally Known ✓ OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 <br />