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(16-04-05) School Crossing Guard Services
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American Guard Services
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Last modified
5/25/2016 4:44:52 PM
Creation date
5/25/2016 4:44:44 PM
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Template:
CityClerk-Bids_RFP_RFQ
Project Name
School Crossing Guard Services
Bid No. (xx-xx-xx)
16-04-05
Project Type (Bid, RFP, RFQ)
Bid
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1 <br /> ANTI - KICKBACK <br /> • <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> Sunny Isles Beach,FL 33160 <br /> Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA Califorrjia <br /> ' COUNTY OF Los Angeles ) <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 /> 1 <br /> By: Sherif Assal <br /> 1 Title: President <br /> 1 The foregoing instrument was acknowledged before me this 2_ day of <br /> �l , 20 (1p, by Sherif Assal [name <br /> 1 of pers ], as President [type of authority], for <br /> American Guard Services, Inc. [name of party on behalf of whom instrument was <br /> 1 executed]. <br /> AFFIX NOTARY STAMP HERE: // I. <br /> Co <br /> AmLmissioYSHIAn M.#A2122779 SSAL / <br /> :L Nota 7 Public — State of F#orida-'Ct( 4-orof&, <br /> Notary.Public •California s <br /> T (C-ppf Los Angeles County fa_ H. s4.1 <br /> 1 Comm. E fires Au 9,201s <br /> Print'or Type Commissioned Name <br /> 1 Personally Known 1/ OR Produced Identification <br /> Type of Identification Produced <br /> 1 <br /> 1 <br /> 1 <br /> DECWEER 28,2010 7 of 10 <br /> 1 <br />
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