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STATE OF FLORIDA <br />COUNTY OF Z>&D- ) <br />ANTI -KICKBACK <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beack FL 33180 <br />Telephone: (305) 947-0508 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 />Title: �� %.,�G i�, 5 <br />The foregoing instrument was acknowledged before me this 26 day of <br />06 20 ZS by yND-Tf Cu W UAS [name <br />of person], as 7i;� 1PL&4 r [type of authority], for <br />COM- iCcl'rl a IMS [name of party on behalf of whom instrument was <br />execufedl. r <br />AFFIX NOTARY STAMP HERE: <br />,a"II011-1 <br />1, YOHANIA CHAMIZO <br />Notary Public -State of Florida <br />Commission d HH 220934 <br />My Commission Expires <br />April 18, 2026 <br />Notary PuY lic - State)Df Florida <br />C4 W4t191a 64A&Itw <br />Print or Type Commissioned Name <br />Personally Known OR Produced Idenl-ification <br />Type of Identification Produced <br />VECEMe6R28,2010 <br />