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Landscape Architecture 16-12 <br /> I <br /> t'U_M/ : <br /> %y" Q \,= ANTI - KICKBACK <br /> 7City of Sunny Isles Beach <br /> ;,(."- -4-7-E7.,1* <br /> o,` 18070 Collins Avenue <br /> b io• Sunny Isles Beach,FL 33160 <br /> C„ <br /> 'o.,v 'yo Telephone:(305)907-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> I • <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 /> Oby an officer of the corporation. <br /> IBy: / t....2IfDavid Carter, CCM er <br /> Title: Senior Vi - President <br /> i <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 /> 0 executed]. <br /> AFFIX NOTARY STAMP HERE: ri-,,,v,e_ <br /> qt,,,,c, , <br /> Notary Public— State of Florida <br /> 1 4.1int„�.,, JULIA FORGIONE 1 <br /> f 3 y„i (11 Notary Public-Slate o1 Florida 1 Julia Forgione <br /> I i• •"p My Comm.Expires Nov 4,2015 <br /> i %;.q--�.��d; Commission ! EE 137341 r Print or Type Commissioned Name <br /> ''8..�'' Bonded Through National Notary Assn. 1 <br /> IPersonally Known ✓ OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> I <br /> I <br /> DECEMBER 28,2010 7 of 7 <br /> I0006.027944.0512 Atkins I City of Sunny Isles Beach, RFQ No. 12-04-02 <br />