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0 <br /> 0 <br /> 0 <br /> 0p..,,,, <br /> 0 ��_ ANTI - KICKBACK <br /> 0 City of Sunny Isles Beach <br /> 18070 Coke Avenue <br /> o• Sunny I:es Beach,FL 33160 <br /> 0 0.)44 Telephone:(305)947-0608 Fax:(305)9543113 <br /> O ANTI-KICKBACK AFFIDAVIT <br /> 0 <br /> O STATE OF FLORIDA <br /> ® ) <br /> 0 <br /> COUNTY OF ..1)(4 ) <br /> ® I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid <br /> 0 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 /> 0 by an officer of the corporation. <br /> 0 <br /> 0 By: <br /> ® Title: l uiPAi <br /> ® The foregoing instrument was acknowledged before me this 2 7 day of <br /> JA>A1 20 I t. by l„•ec ,N. [name <br /> 0 of person], as Co I, o, ,w, [type of authority], for <br /> ® )'/.h;c,./h..j C,frod i f [name of party on behalf of whom instrument was <br /> executed]. <br /> 0 <br /> ® AFFIX NOTARY STAMP HERE: <br /> otary Public—State of lorida <br /> ® Notary Pubic Stew w Fiords <br /> Zenaida FernaanEdez /}J-//n 'O <br /> �wws E>alaasplry7Q018187904 /l•",TCgt ice 4a4'4? <br /> ® lt01.8 Print or Type Commissioned Name <br /> 0 Personally Known `— OR Produced Identification <br /> 0 Type of Identification Produced <br /> 0 <br /> 0 <br /> 0 <br /> ® oecaneem,2olo 7of7 <br /> 0 <br /> 0 <br /> 0 <br /> O Curtis + Rogers Design Studio RFQ 12-04-02 60 <br /> 0 <br />