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STATE OF FLORIDA ) <br />) <br />COUNTY OF PALM BEACH ) <br />ANTI-KICKBACK <br />City of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isl es Beach, FL 33160 <br />Telephone: (305) 947-0606 Fax: (305) 949-31 13 <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: President <br />The foregoing <br />August <br />instrument was acknowledged before me this 11th day of <br />20~, by Matthew F. West [name <br />of person], as President [type of authority], for <br />West Architecture+ Desig n, LLC [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: ~g;d)]"h~~t-,,t-(-- <br />~~(I.Y PIJq( RACQUELJ. BARRETT tW:: Commission# HH <br />6 <br />4 <br />2 <br />1 <br />0 <br />4 <br />2 <br />8 <br />7 <br />20 <br />•~ Expires June 2 , <br />Notary Public -State of Florida <br />/, <br />Personally Known ✓ OR Produced Identification ____ _ <br />Type of Identification Produced _____________ _ <br />DECEMBER 28, 201 0 <br />115