Laserfiche WebLink
1 <br /> SUNNY ,,,F <br /> f <br /> - ANTI - KICKBACK <br /> V 1 Z <br /> • <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> �Y .'•r i o�oa+ Sunny Isles Beach.FL 33160 <br /> '� Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ' ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF Miami-Dade) <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: Rudy M. Ortiz, P.E. (a � <br /> Title: CEO <br /> 1 <br /> The foregoing instrument wa acknowledgged before me this 1 day of <br /> ' May , 20 12 , by Mdy A-I. urn , C.o [name <br /> of person], as [type of authority], for <br /> [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: / <br /> f( 1 <br /> Notary Pu�tate of <br /> CHRISTINE HANYOK <br /> �:,.- NOTARY PUBLIC L <br /> ' �' . STATE OF FLORIDA C.r l c�s{in e, flan yak <br /> Y%fit"' `' Came DD0918218 <br /> ��;�;,��;,� Print or Type Commissioned Name <br /> Expires 9/12/2013 <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> e <br /> 1 <br /> 1 City of Sunny Isles Beach Continuing Professional Architectural&Engineering Services RFQ 12-04-02 I 48 <br />