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(16-03-01) Motor Coach Transportation
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Last modified
3/31/2016 10:45:41 AM
Creation date
3/31/2016 10:45:41 AM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
Motor Coach Transportation Services
Bid No. (xx-xx-xx)
16-03-01
Project Type (Bid, RFP, RFQ)
Bid
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4VNNY,, F <br /> t----17,-- ,40, <br /> I \_ ANTI - KICKBACK <br /> City of Sunny Isles Beach <br /> � 18070 Collins Avenue <br /> '• rLo• Yo+` Sunny Isles Beach,FL 33160 <br /> Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF BROWARD ) <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 /> By: .44 <br /> Title: VICE PRESIDENT <br /> The foregoing instrument was acknowledged before me this 29TH day of <br /> MARCH 2016 by MIKE CASTRO [name <br /> of person], as VICE PRESIDENT [type of authority], for <br /> CORPORATE COACHES INC. [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: QAil rgiLen't4 -� <br /> ELIZABETH FREEMAN Nota ublic — State of Florida <br /> ,-Y'.' NOTARY PUBLIC <br /> `F '-- STATE OF FLORIDA rY, ktp,..{. <br /> -1-. <br /> ,o Print or Type Commissioned Name <br /> Personally Known OR OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28.2010 7 of 7 <br />
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