Laserfiche WebLink
SUNNY IS,F <br /> '"' ANTI -KICKBACK <br /> �'.`� " �• City of Sunny Isles Beach <br /> ti'- �`T.` 18070 Collins Avenue <br /> •1;i-i-- --0-0)-roS i Sunny Isles Beach,FL 33160 <br /> o. ,u '� Telephone:(305)947-0606 Fax.(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF Broward ) <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: Robert M. Dugan <br /> Title: Principal <br /> The foregoing instrument was acknowledged before me this 30 day of <br /> APRl - , 20 0- by R013E/Cr Al. bcurA2v [name <br /> of person], as PR A) C i pit L- [type of authority], for <br /> Yb5,4 ,.TN C. • [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> A. .. / :..t . ". ./ <br /> Nota Pub!- — State of Florida , <br /> I zp114e, MARY ANNE STANLEY 0 <br /> 4 i .1`�'s Notary Public-State of Florida , M fl/ -\/ AA1 SCJ E STAJ LE y <br /> � .3 '.` My Comm.Expires Dec 15,2015 Print or Type Commissioned Name <br /> Commission# EE 123433 Yp <br /> 4 'tR,\(, Bonded Through National Notary Assn, <br /> rwrownerre <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28,2010 7 of 7 <br />