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SLLHIs E+ <br /> ANTI - KICKBACK__ <br /> ® �� City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> .r o� ' Sunny Isles Beach,FL 33160 <br /> C"'0. w.. 'Is0,• Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> COUNTY OF Miami-Dade ) <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 /> /' <br /> By: Br- B ' t-n it <br /> Title: General Manager <br /> The foregoing instrument was acknowledged before me this 23rd day of <br /> March , 2016 , by Rret T Rritlenum [name <br /> of person], as General Manager [type of authority], for <br /> Academy Rim, I 1 r [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: <br /> vb <br /> Dayienis Almira No Public — State of Florida <br /> � .Commission#EE863910 —r� <br /> -r%� e`c GirBO Jan.09,2017 // /ents h1fv 'i <br /> ,E GF R°p$ ; y&S TH'n0 <br /> „, AAA NOTARY 6 SURETY BONDS Print or Type Commissioned Name <br /> Personally Known x OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28.2010 7 of 7 <br />