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SVXXT/,,f <br /> ANTI - KICKBACK <br /> :CS;-1-41, z City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> •n o +o Sunny Isles Beach.FL 33160 <br /> o,.u+' Telephone:(305)967-0606 Far(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA, ) <br /> COUNTY OF f lon'll r ) <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: -€-iZiKtk lann1S 4A-/-9-- • <br /> Title: chroc FGT tSi7Cecz012._ - <br /> The foregoing instrument was acknowledged before me this (O day of <br /> oiT , 20 /r, by CMMA Gw.ris [name <br /> of erson], as itt7 tCer• �� ,4 [type of authority], for <br /> it°"`L G /3'IA( ' [na e of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: / f 1 <br /> Notary • ublic —State of Florida <br /> ttblifc4 t/enscs <br /> Print or Type Commissioned Name <br /> Personally Known ORoduced Identification om <br /> Type of Identification Produced frconti4 QM vu.) L.cc,.:56 <br /> D=cZXaan 28,2010 7 of 10 <br />