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Danella Utility Construction Inc.
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(15-12-02) Utility Undergrounding
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Danella Utility Construction Inc.
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Last modified
1/7/2016 4:17:12 PM
Creation date
1/7/2016 4:17:07 PM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Collins Ave. Utility Undergrounding
Bid No. (xx-xx-xx)
15-12-02
Project Type (Bid, RFP, RFQ)
Bid
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ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FlorI J4 <br /> p ) SS: <br /> COUNTY OF Palm r. ccs <br /> I, the undersigned hereby duly sworn, depose and say that no portion of the sum herein bid will be paid to <br /> any employees of the City of Sunny Isles Beach and its elected officials, as a commission, kickback, <br /> reward or gift, directly or indirectly by me or any member of my firm or by an officer of the corporation. <br /> By: / <br /> /1 <br /> \Rub Preside/Ai <br /> (Title) <br /> Sworn and subscribed before me this <br /> �/ <br /> !61=> day of WEL _.�, , 20 <br /> / 10 � <br /> NOTARY PUBLIC <br /> State of Florida at ,, LEONA ANN ODEN <br /> •.--•r ,-��,�^ / t%✓ ' Notary Public-state of Florida <br /> t F My Comm.Expires Aug 29.2018 <br /> .",;•—, <br /> 4. Commission r FF 118289 <br /> = -My Comission pine „8' <br /> Assn. <br /> 00300- 17/26 <br />
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