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HBC Engineering Co.
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(12-04-02) Professional Architectural and Engineering Services - Firms Only
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HBC Engineering Co.
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Last modified
2/1/2016 4:20:40 PM
Creation date
2/1/2016 4:19:13 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Professional Architectural and Engineering Svcs
Bid No. (xx-xx-xx)
12-04-02
Project Type (Bid, RFP, RFQ)
RFQ
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ANTI - KICKBACK <br /> • <br /> • �� • City of Sunny Isles Beach <br /> •�� C c,. 18070 Collins Avenue <br /> 4' ''•sLoo4' Sunny Isles Beach,FL 33160 <br /> a, sus s" Telephone:(305)947-0606 Fax(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <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: A ebayo T.Coker <br /> Title: President <br /> The foregoing instrument was acknowledged before me this 3I2 day of <br /> �pu2i�� , 20/Q , by Ape 17G {Jo [name <br /> of person], as pa 57'ctp ci f [type of authority], for <br /> 7/(3G r/2 c,'7'1ep,' ,A� .w727 )'[name of .. • . .� �+, Hp% . Instrument was <br /> executed]. �.. ;;= Commission#EE 171091 <br /> L,o Expires February 19,2016 <br /> mas nN Tioy F31 h.ramma.zsrala <br /> AFFIX NOTARY STAMP HERE: <br /> Notary Public— State of Florida <br /> Print or Type Commissioned Name <br /> Personally Known // OR Produced Identification it1/4 - <br /> Type of Identification Produced <br /> DECEMBER 28,2010 7017 <br />
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