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STATE OF FLORIDA <br />COUNTY OF <br />ANTI -KICKBACK <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 />1, 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. n 17 <br />The foregoing instrument <br />I <br />2017 by <br />of erson], as <br />ap-017-PA 1-fCChA-­fr,4-j _66 A <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />JOSE ANTONIO ALONSO <br />Commission # FF 083252 <br />Expires February 22, 2018 <br />BWod 7hru Troy Fain Instuance 8W385.7019 <br />a <br />- Q%$% <br />Title: 1-0me Pj;Lrg&10aW41r_ <br />was acknowledged before me this day of <br />• 6'v1s45o(,-_ [name <br />[type of authority], for <br />4ci?,,A[name of party on behalf of whom instrument was <br />No Public — State of Florida <br />Print or Type Commissioned Name <br />ersonall Kn <br />rso "Y-,Kno OR Produced Identification <br />of t? <br />Ir <br />fra <br />_ t <br />*yyppe of Identification Produced <br />DEcEmoER28,2010 7 of 10 <br />