Laserfiche WebLink
s�NNV rs <Ff, <br />� y <br />C1 Of SUN F, <br />STATE OF FLORIDA ) <br />COUNTY OF Mlgmf 94 ) <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: y IN ce- fire s °e vt+ <br />foregoing instryment was acknowledged before me this day of <br />2QS by [name <br />of pe on], as [type of authority], for <br />[name of party on ',-half of whom instrument was <br />executed]. " � % _ /i <br />AFFIX NOTARY STAMP HERE: <br />tppy pOB Notary bIIC - State of FlffiLrida <br />r° ; •••. ��r MARIA E. HERMWE,7 <br />* * My'00MMISSION # FF 19910D <br />EXPIRES, Aprll 7, 2019 <br />N�arFOF Fl-"'' Boded Thru Budget Notary services Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 7 of 10 <br />