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a <br /> ® SVNYI IS[F., <br /> ANTI — KICKBACK <br /> ® :) City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> 0 <br /> 'D°'•pro` r^ Sunny Isles Beach,FL 33160 <br /> Telephone:(305)947-0606 Fax:(305)949-3113 <br /> S <br /> ® ANTI-KICKBACK AFFIDAVIT <br /> 0 <br /> • STATE OF FLORIDA <br /> • <br /> COUNTY OF Miami-Dade ) <br /> e <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.0 <br /> // <br /> • By: gra ! a UU� <br /> ® Title: President II <br /> • <br /> • <br /> • The foregoing instrument was acknowledged before me this ..2r711 day of <br /> • <br /> 20 4-1- by Kathryn O'Leary Richards [name <br /> of person], as President <br /> ® Ott galitrzis Des�� [typef of authority],mn as <br /> Ottani Assx.a lac - [name of party on behalf of whom instrument was <br /> • executed]- <br /> •® AFFIX NOTARY STAMP HERE: - <br /> ® el' NotaryPubli — State of Florida <br /> aaadkalaSeasaame <br /> 1 �,,.�„�, GERARDO E.DELANEY � <br /> ® 4 ;�o —1 `t,; Notary Public-State o1 Florida <br /> My Comm. Expires Sep 17.2011 <br /> Commission # EE 25361 t <br /> `%°;.I:'`` Eonaec through National Notary Assn. I Print or Type Commissioned Name <br /> dliglirrninnrirrn <br /> ® Personally Known OR Produced Identification <br /> O Type of Identification Produced GG D�'r�� G'cense <br /> ® DECEMBER 28,2010 7 0f 7 <br />