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' JNNY IS< <br /> ' - _, ANTI - KICKBACK <br /> V� <br /> ): City of Sunny Isles Beach <br /> ,_ Y 16070 Collins Avenue <br /> .,io <br /> ' 'r •rio�� •C Sunny Isles Beath,FL 33160 <br /> Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ' ANTI-KICKBACK AFFIDAVIT <br /> I STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF BROWARD I <br /> I, the undersigned, hereby duly sworn and deposed say ' at no •onion of th' m herein Bid <br /> will be paid to any employees of the City of Sunny, sles Be-ch or its - ected officials as a <br /> I . commission, kickback, reward or gift, directly or . ,4ay b e or y member of my firm or <br /> by an officer of the corporation. 1 <br /> I <br /> By: Al A <br /> As <br /> ITitle: 4 • dent <br /> rforegoing instrument was a. ,,.wled• -. before me this I day of <br /> , 20 1 Z by s [name <br /> I of p rson as tctS [type of authority], for <br /> 6,71- Ft [name of party .n b:half of whom instrument was <br /> executed]. <br /> IAFFiX.NOTARY STAMP HERE: , <br /> INotary P' • — State of Florida <br /> WANDA QUINTANA <br /> (per MY COMMISSION DDS01i02 <br /> 1100,-44_, U� II I {r,-. EXPIRES:JOY-,0.2011 <br /> o-Y ;CO Print or Type Commissioned Name <br /> I Personally Known C.7. <br /> OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> I <br /> I <br /> IDEtevgra 26,zolo 7 of 7 <br />