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STATE OF FLORIDA ) <br />} <br />COUNTY OF e ) <br />ANTI -KICKBACK <br />City of Sunny Isles Beach <br />18x70 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 instrument was acknowledged before me this .27 day of <br />c1.ff , 20 -Ar,_ by cP,,�46m2fz [name <br />of person], as [type of authority], for <br />[name of parry on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />` JARENYS ROORiGUEZ <br />YGOMINISSION#HN 125343 <br />eodF �cP EXPIRES: AuMt 31, 2025 <br />00F ThI7[ <br />Print or Type Commissioned Name <br />Personally Known Jz OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2016 <br />