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Curtis + Rogers Design Studio, Inc. Bid Document (10)
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Curtis + Rogers Design Studio, Inc. Bid Document (10)
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AFFIDAVIT OF COMPLIANCE WITH FOREIGN ENTITY LAWS <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 />The undersigned, on behalf of the entity listed below ("Entity"), hereby attests <br />under penalty of perjury as follows: <br />1.Entity is not owned by the government of a foreign country of concern, as <br />defined in Section 287.138, Florida Statutes. <br />2.The government of a foreign country of concern does not have a controlling <br />interest in Entity, as defined in Section 287 .138, Florida Statutes. <br />3.Entity is not organized under the laws of a foreign country of concern, as defined <br />in Section 287 .138, Florida Statutes. <br />4.Entity does not have a principal place of business in a foreign country of concern, <br />as defined in Section 287.138, Florida Statutes. <br />5.The undersigned is authorized to execute this affidavit on behalf of Entity. <br />Date: Au gust 13 ,20� <br />Entity: Curtis + Rogers Design Studio, Inc. <br />STATE OF Florida------ <br />COUNTY OF Miami Dade <br />Signed: __________ _ <br />Name: Olivia Bussey <br />Title: Principal <br />The foregoing instrument was acknowledged before me, by means of □ physical <br />presence or □ online notarization, this 13 day of _A_u_g _u _st ____ , 201§__, by <br />Olivia Bussey as Principal for <br />---=-C -=urt:...::..:i=-s _+....:...R..o..,,o:..;igc=e.:....::rs:......::D::....,e=s:..:...ig;J..'-'nC.....,S.,_,,t.=.;ud:::,..:.i=.,o _,_l .:....,.;nc"'"'". _____________ , who is personally <br />known to me or who has produced _ __._pe_r_s _on_a _ll_y_k_no_w_n _____ as identification. <br />Notary Public Signature: ....___�::.....;....,.......:.----,,-..;;:....�...,.+,-- <br />Print Name: ____ ..........,.,,._ ____ _ <br />State of Florida at Large (Seal) <br />My commission expires: May 18, 2027
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