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NNS• <br /> J5 <br /> k SV (FJ <br /> • ANTI - KICKBACK <br /> City of Sunny Isles Beach <br /> 18070 Collins Avenue <br /> o. Sunny Isles Beach,FL 33160 <br /> o. iu'. ' Telephone:(305)947.0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF <br /> South Caro Ina ft Wat ) <br /> ) <br /> COUNTY OF York ) <br /> • <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: <br /> Stephanie Rinsone <br /> Title: Sr. Customer Contrac Manager <br /> The foregoing instrument was acknowledged before me this 22nd day of <br /> August , 20 16 by Stephanie Ransone [name <br /> of person], as Sr. Customer Contract Manager/Representative [type of authority], for <br /> Sunbelt Rentals, Inc. [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: C <br /> L nnsuna Pasquarelli Notary Public — State of-Florida South Carolina <br /> Nctary Ps*,State of Sod Caro6,a <br /> My COMMLlial Expires June 19,2425 ns4i u` <br /> Print or Type Commissioned Name <br /> Personally Known X OR Produced Identification <br /> Type of Identification Produced n/a - — <br /> DECEMBER 28,20ti0 7 of 7 <br /> S9 <br />