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`y,NNY IJ<ff <br /> V•im' "` ANTI - KICKBACK <br /> o-E <br /> ® u z City of Sunny Isles Beach <br /> � <br /> 18070 Coffins Avenue <br /> *rx""•J sowoSunny Isles Beach,FL 33160 <br /> •. <br /> t' o. vv"�v 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 /> • <br /> By: <br /> R. Harvey Sasso <br /> Title: President <br /> ® The foregoing instrument was acknowledged before me this 27 day of <br /> April , 2012 by R. Harvey Sasso [name <br /> of person], as President [type of authority], for <br /> Coastal Systems International, Inc . [name of party on behalf of whom instrument was <br /> executed). <br /> AFFIX NOTARY STAMP HERE: <br /> 7 <br /> N a •ry Public — State "f Florida <br /> Vanessa Russi-Machado <br /> Print or Type Commissioned Name <br /> Personally Known X OR Produced Identification <br /> Type of Identification Produced <br /> i Oro Notary Public State of Floridan. <br /> Vanessa Russi-Machado <br /> ' my commission EE017222 <br /> ® ?oino` Expues 10/14/2014 <br /> DECEMBER 28,2010 7 of 7 <br />