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O`y,NN♦,,,_ <br /> ANTI - KICKBACK <br /> 41, ral <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> '•r1o�' Sunny Isles Beach.FL 33160 <br /> o. ,vv ' 4� Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> Commonwealth of Massachusetts <br /> STATE Of FLORIDA <br /> COUNTY OF Middlesex ) <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: /..if <br /> Title: S= for Vice L._-••-T',Global Sales <br /> S die foregoing instrument was acknowledged before me this �t' day of <br /> LekMe <br /> f )/11 i 20 bx Dia G [name <br /> of perso` n], as Sr, tee. I'feii dnt b M i) 3a Le--; [type of authority], for <br /> r\VCYIOS zfle))rporr-ed [name of party on behalf of whom instrument was <br /> executed]. n <br /> AFFIX NOTARY STAMP HERE: l ( ) et4G ) <br /> H Nt' Notary Public — State-of-Florida <br /> Not y Public Commonwealth of Massachusetts <br /> i. M*SSCC$ETTS <br /> M' Commission Expires Dabdfal L. -�j�ci/ rsg <br /> 30. 2021 !'�� 0'"1^v <br /> Print or Type Commissioned Name <br /> Personally Known / ' OR Produced Identification <br /> Type of Identification Produced <br /> S <br /> DECEMBER 262010 7 017 <br />