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SUNNY �S�F <br />h. Y <br />F- LOp�QOS,�P <br />a <br />Ty OF SUN P <br />GEORGIA <br />STATE OF Ft{3RB3 -A ) <br />) <br />COUNTY OF FULTON ) <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: <br />Title: Senior Vice Pre ident <br />The foregoing instrument was acknowledged before me this ld day of <br />A�r� , 20 15' , by Benjamin J. Carnazzo [name <br />of person], as Senior Vice President [type of authority], for <br />Kiewit Infrastructure South Co. [name of party on behalf of whom instrument was <br />otary Public — State of -FWida GEORGIA <br />Jamie L. Cooper <br />Print or Type Commissioned Name <br />Personally Known x OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 7 of 10 <br />