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G. Batista - Traffic
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(12-04-02) Professional Architectural and Engineering Services - Firms Only
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G. Batista - Traffic
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Last modified
2/5/2016 3:39:53 PM
Creation date
2/5/2016 3:39:53 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Professional Architectural and Engin. Svcs
Bid No. (xx-xx-xx)
12-04-02
Project Type (Bid, RFP, RFQ)
RFQ
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I `yJNNY ts,,, <br /> . '-' ANTI - KICKBACK <br /> n <br /> I v(- ' z <br /> City of Sunny Isles Beach <br /> ' - ' <br /> 18070 Collins Avenue <br /> • ' •,t0•' o% Sunny Isles Beath,FL 33160 <br /> ITelephone:(305)947-0606 Fax:(305)949-3113 <br /> I <br /> ANTI-KICKBACK AFFIDAVIT <br /> I STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF BROWARD ) <br /> II, the undersigned, hereby duly sworn and deposed say that no portion of this su . herein Bid <br /> will be paid to any employees of the City of Sunny Isles Beach or its eke -. off', als as a <br /> ' commission, kickback, reward or gift, directly or indirectly by me or any t -tuber . my firm or <br /> by an officer of the corporation. , <br /> ,IM�� <br /> I <br /> _ P, / <br /> By: 4 S Asp <br /> I '� <br /> Title: President k <br /> I Err <br /> e foregoing instrument was a now -duel befor: day of <br /> 20(11 by s s [name <br /> of per ], g4. ��3 • [type of authority], for <br /> C� [name of party o .ehalf of whom instrument was <br /> executed]. <br /> 0 AFFIX NOTARY STAMP HERE: 1/� , <br /> �, i <br /> ' V <br /> INotary Public State of Florida <br /> WANDA QUINTANA / �j <br /> MY COMMISSION 3 ,2012 02 �11°�� 6,;7 (T� <br /> EXPIRES:July 30,2012 <br /> bx.-JDGRl. FtNcnnDiscount 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 /> DECFLISF0 28,2010 7 of 7 <br />
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