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<br />SECTION 21 <br />ANTI -KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA <br />COUNTY OF ~b€ <br /> <br />) <br />) <br />) <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum <br />herein bid will be paid to any employees of the City of Sunny Isles Beach or its elected <br />officials as a commission, kickback, reward or gift, directly or indirectly by me or any <br />member of my firm or by an officer of the corporation, <br /> <br />By: <br /> <br />~~ <br /> <br />~b'11 t:m4 J4{~4~ <br /> <br />-.i <br /> <br />Title: <br /> <br />r) \ b. <br />The foregoing instrument was ^~:knoWledged\\before me this I, of <br />\X.-:{"-~N\De( , 20 Cl, by ~\C\ (ODcI -er\. .__ <br />. [pame of person], as (,( (\f~(l\ f\J(t()(I&Je'( [type of authl,('cy], for <br />\II\{ \ c', c.;,..y, LLk"\r1 ~(.Opl :J~ [name of party on behalf of whon I Instrument <br />was executed]. <br /> <br />A~~~~~I,~?T~RYJ Sl~~he~ERE: <br /> <br />/J~~':>'., ' . . "I jD582718 <br />:.;', ~'f, .~= ,I'~ 08 2010 <br />~r(.~~~~"". ,nuIJ, I <br />""4';'?'~I~';....';'~n'. " nM or~ l'~ OT ARY,com <br /> <br />~~~~~'~)cate of Florida <br /> <br />W\')(I ~\CI~Jtf\ ~ 7 <br />Print or -', Of' '::.'Jrnmissioned Name <br /> <br />Personally Known V OR Produced Identifica',';' 11___ <br />Type of Identification Produced . _ __- <br /> <br />E.. D OF SECTION <br /> <br />PAGE 91 OF 92 <br />BID No. 07-10-04 <br />