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SOp1NY IS,E <br />A y <br />h N <br />1 <br />fIOF 0 M1 <br />STATE OF FLORIDA ) <br />COUNTY OF sroward ) <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: : % 1 <br />/dames A. Royo <br />Title: President <br />The foregoing instrument was acknowledged before me this 2ot-h day of <br />April , 20is f by .Tames A. Royo [name <br />of person], as President [type of authority], for <br />Shoreline Fonndation. Inc. [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />Notary Public —State of Florida ' <br />P Public 8lsle of Florida <br />oseph Stanton <br />y Commission EE 827488 xpires 88/28/2618 Print or Type Cbdmigsioned Name <br />Personally Known x <br />Type of Identification Produced <br />OR Produced Identification <br />oECeta 28.2016 7 of 10 <br />