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I <br /> Mioff <br /> lt ANTI - KICKBACK <br /> ICity of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> • 0'., io,s•°o� Sunny Isles Beach,FL 33160 <br /> ITelephone:(305)947-0606 Fax:(305)949-3113 <br /> ' ANTI-KICKBACK AFFIDAVIT <br /> I STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF BROWARD ) <br /> II, the undersigned, hereby duly sworn and deposed say tha o portio• of this sum her-in Bid <br /> will be paid to any employees of the City of Sunny - V: :-ach o its elected s--cials as a <br /> 1 commission, kickback, reward or gift, directly or indil- iii e o• any mer ser of my firm or <br /> by an officer of the corporation. i) ft <br /> I By las <br /> ITitle: Presla <br /> IT,,-- foregoing instryfient was,, kroyledged before me this ( day of <br /> (�;� <br /> 20( /i, by CQ' -J -- [name <br /> I of persons$ as ref [type of authority], for <br /> (;P4t [name of party o, behalf of whom instrument was <br /> executed]. <br /> IAFFIX NOTARY STAMP HERE: <br /> lI <br /> I . Nota • u • 'c — State of Florida <br /> µ'ANDA QUfNTANA { f 0a� \141.r <br /> MY l/ <br /> COMMISSION 9 DD801302 LJ <br /> EXPIRES:July 30,2012 <br /> 14:03NO..U. Fl NowyThscpin Assoc co Print or Type Commissioned Name <br /> IPersonally Known OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> I <br /> I <br /> IDECEMBS326,2010 7 of 7 <br />