Laserfiche WebLink
• <br /> 0 . <br /> ® 4Of NNT iii.4e <br /> ' 1Cf • <br /> cT, ANTI - KICKBACK • <br /> ® • • <br /> City of Sunny Isles Beach <br /> ® •.,z �- 18070 Collins Avenue <br /> e OT <br /> ''�� '•rro�� Sunny Isles Beach,FL 33160 <br /> ® 'or run'es, Telephone:(305)947-0606 Fax(305)949-3113 <br /> • <br /> ® ANTI-KICKBACK AFFIDAVIT <br /> • . <br /> ® STATE OF FLORIDA ) <br /> • ) <br /> COUNTY OF Hta1•t(_ ) <br /> • <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 /> • by an officer of the corporation. <br /> 0 <br /> ® By: �(� <br /> • <br /> ® Title: President <br /> 0 <br /> ® The foregoing instrument was acknowledged before me this 9th day of <br /> ® April , 20 12 by Adriana Savino-Miller '[name <br /> • of person], as President [type of authority], for <br /> ® Savino& Miller Design Studio, P.A. [name of party on behalf of whom instrument was <br /> ® executed]. <br /> ® AFFIX NOTARY STAMP HERE: er <br /> ® Notary Public— S r to of Florida <br /> imillhasaiaidiadisaaaa <br /> 1 ..••':n•....... <br /> ays, CRISTIANA GRULLON I I <br /> 0 15` `�1 �:: Notary Public-State of Florida I �1 a4 r far)1� A is((h 1 I <br /> ® 1 ; �n7 =My Comm.Expires Aug 26.2015 I Print or Type Commissioned Name <br /> 1 re-rt, ' Commission 0 EE 100586 • <br /> • Personally Known OR Produced Identification frz- <br /> ® Type of Identification Produced Fi- PL' 1-4 4.0 0—o67—go --9T& -o <br /> • <br /> • <br /> • <br /> • <br /> • <br /> • <br /> 0 oeceuaea 2s.2010 7 of 7 <br />