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Isolanv rs,F <br /> I <br /> ANTI - KICKBACK <br /> VI— '.1 <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> �1 '.',C1.:5±1—"-‘017[•°t <br /> ' r• o•�oo•` Sunny Isles Beach,FL 33160 <br /> it or sus '• Telephone:(305)947-0606 Fax:(305)949-3113 <br /> 1 ANTI-KICKBACK AFFIDAVIT <br /> I STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF BROWARD ) <br /> II, the undersigned, hereby duly sworn and deposed say that S .1 ion of this sum her-•• : . ' <br /> will be paid to any employees of the City of Sunny Isl-. :each .r its electe. : Icials as a <br /> I commission, kickback, reward or gift, directly or indire 4P, <br /> , Ime or any m- .er of my firm or <br /> by an officer of the corporation. <br /> IBy: � I/� <br /> II Title: P -sir " / <br /> IT foregoing instrument was a; n. -dged befor= me this ( day of <br /> 20 ( Z by ' I [name <br /> I of person] as . s [type of authority], for <br /> (9 x'31 [name of pa - on behalf 9 whom instrument was <br /> executed]. <br /> I AFFIX NOTARY STAMP HERE: <br /> ) <br /> / I <br /> I T0P" <br /> • <br /> �\rp�DA QuN0050130'- No ry Public — Sta - of Florida <br /> ,. MY C0�1�7155,0�30.2012 <br /> 7 FI.`�om1Y0'' a Ps+a C°' f Q1 V",ja. ill (11 <br /> Iyp1ARY SCJ <br /> Print or Type Commissioned Name <br /> UPersonally Known `� OR Produced Identification <br /> Type of Identification Produced <br /> I <br /> I <br /> I <br /> I I DECEMBER 28,2010 7 of 7 <br />