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I <br /> ,MEr,k <br /> I <br /> ANTI – KICKBACK <br /> ' �` City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> ' �—o:' Sunny Isles Bead.FL 33160 <br /> „ a <br /> o, �u Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> ISTATE OF FLORIDA ) <br /> ) <br /> ' COUNTY OF Palm Beach) <br /> I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br /> I 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 /> 1 <br /> By: <br /> ITitle: .41,1111Pe President/Principal <br /> IThe foregoing instrument was acknowledged before me this "o day of <br /> -ort ( , 20 IA , by • �1�11-t 5 . U�_2,c Uwk6t_ [name <br /> I of person], as L kc>' ?-)n, r-4.p v) -{- [type of authority], for <br /> 1\11e00 4\cn sooicLks/Th- _ [name of party on behalf of whom instrument was <br /> executed]. <br /> IAFFIX NOTARY STAMP HERE: q l <br /> Ac.l&k,c 4_Livuuz- <br /> I Notary Public- State of Florida <br /> 3!by Notary Public State o1 Florida <br /> '4$ Hal=_n s Venetucu i� I\ <br /> ' MI.Commission DD759632 ---r Y.�n e u c_c f <br /> %0 �s ..r,esoazazo,z Print or Type Commissioned Name <br /> I4—rsonall Known OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> I <br /> I <br /> CECEIBER 28,2010 7 of 7 <br />