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o. ,.•:.,. ANTI - KICKBACK <br /> �, City of Sunny Isles Beach <br /> `o 18070 Collins Avenue <br /> i o° Sunny Isles Beach,FL 33160 <br /> o ‘40 Telephone:(305)947-0606 Fax:(305)949.3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF ) <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: Rarthnlnmew Okorn <br /> Title: President <br /> The f regoing instrument was acknowledged before me this 5 day of <br /> , 20/5,-, by [name <br /> of pe n], as [type of authority], for <br /> [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> .: S ta al rL.-1,. $ <br /> 1" HENRY JOACEUS i tary Pu c - State of Florida <br /> •(1).1 MY COMMISSION kFF110248 <br /> \ ef%` EXPIRES April 7. 2018 <br /> (407)398-0153 FlorlaaNtaryServlce.com Print or Type Commissioned Name <br /> ot <br /> Personally Known V OR Produced Identification <br /> Type of Identification Produced <br /> DtceyeER 28.2010 7 of 10 <br />