Laserfiche WebLink
a • <br /> __ -__ __ -. _ . Architecture' 6-12 <br /> IVNNT,bx <br /> � - 0- xi' ANTI - KICKBACK <br /> .:-/. <br /> _Q_. . <br /> 1 T <br /> q <br /> •• City of Sunny Isles Beach <br /> '•`J`o�` 18070 Collins Avenue <br /> s. • ,p• Sunny Isles Beach,FL 33160 <br /> ''o.no,'i0 Telephone:(305)947-0606 Fax:(305)949-3113 <br /> I <br /> ANTI-KICKBACK AFFIDAVIT <br /> 1 <br /> STATE OF FLORIDA ) <br /> COUNTY OF Miami-Dade ) <br /> I 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 /> Iby an officer of the corporation. <br /> 1 By; -�o- 4 V David Carter, CCM <br /> Title: ' Senior Vice President <br /> The foregoing instrument was acknowledged before me this 18th day of <br /> I April , 2012 , by _ David Carter, CCM [name <br /> of person], as Senior Vice President [type of authority], for <br /> Atkins North America, Inc. [name of party on behalf of whom instrument was <br /> Iexecuted]. <br /> AFFIX NOTARY STAMP HERE: <br /> BJULIA FGRGIONE Notary Public — State of Florida <br /> ........ Public•State of Florida <br /> € , la Comm.Expires Nov 0,2015 <br /> 1373a� _ Julia Forgione <br /> A; Commission♦EE Print or Type Commissioned Name <br /> ` '•` Bonded Through National Nally Assn. <br /> • <br /> 1 Personally Known OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> I <br /> I <br /> DECEMBER 28,2010 7 of 7 <br /> I0006112794-4.-0512 Atkins I City of Sunny Isles Beach, RFQ No. 12-04-02 <br />