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Q R <br /> ANTI - KICKBACK <br /> It <br /> City of Sunny Isles Beach <br /> o�,_ 18070 Coffins Avenue <br /> '' r.o�' o. Sunny Lies Beach.FL 33160 <br /> C" �0. sun' Telephone:(305)947-0008 Fat(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF JH1A...; -9A94'_ ) <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 /> . -:'. ----->-------.a/2( <br /> Title: Pit`tii 45,.----,T T. A 2-Pi 4rtr.f6 e--ajiC ea, <br /> hp <br /> The foregoing instrument was acknowledged before me this 3 day of <br /> MA-7 , 20 17, by C;i;/h_72� 'Rt.^,t [name <br /> of person], as Pa1_I25:.S. , ---J [type of authority], for <br /> Auno- J74---.0.-)4...,..-7---,-/— cb. [name of party on behalf of whom instrument was <br /> executed]. <br /> • <br /> AFFIX NOTARY STAMP HERE: <br /> ''� e-, Jt_____A <br /> Notary Public— State of Florida <br /> Fri\ <br /> Notary Public State of Florida / 1 <br /> CindyCap0eva C1ncl �, `° y9dr ;i1L., <br /> My Commission DDa77312 <br /> 'o,,01v Egwes06/19/2013 Print or Type Commissioned Name <br /> Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> oecea3E+zt2010 7 of 7 <br />