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Anti - Kickback Affidavit <br />tf. <br />STATE OF FLORIDA ) <br />Cc (LINTY OF Af'V N " D J' k <br />ANTI - KICKBACK <br />City of Sunny Isles Beach <br />M70 Cp Aw <br />Sunny K" eew,, r: as M <br />Tekp�me f30519!]-0606Ia[ PUS) y}]tll <br />ANTI- KICKBACK AFFIDAVIT <br />I, the undersigned, hereby duly swom 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: /-/,Ai pj "!(''eAc IkXl l Co,, i4✓ <br />The foregoinq instrument was acknowledged before me this ,b Jli day of <br />Ir; 21)_4�__ by LBJk'i/L gI1d'FV4- [name <br />of person], as __ P , � ' [type of authority], for <br />Z6 C, [name of party on behalf of whom instrument was <br />i�t'Py F,,O <br />AFFIX NOTARY STAMP HERE: PAULLOISE,AU <br />w MV COMOSSIONO FF <br />Notary Pudil faf¢� t' 'U, � v <br />.r. fq L) <br />'/ <br />Print or Type Commissioned Name <br />Personally Known OR Pr uced Identrfjcation 6 - � 6D – <br />Type of Identification Produced 17 L ) I ' F, [� /' 2 L,,, fi, r— <br />w.: 1..— v s 11 <br />7d7 <br />30 <br />