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Q SUNNY rs4,. <br /> _° ` ;r ANTI -KICKBACK <br /> ,:,c, <br /> City of Sunny Isles Beach <br /> ' `` '- 18070 Collins Avenue <br /> Z.J''‘e'9r Fj0%‘ S4'~ Sunny Isles Beach,FL 33160 <br /> 'rr or soµ''N Telephone:(305)947-0606 Fax:(305)949-3113 <br /> ANTI-KICKBACK AFFIDAVIT <br /> STATE OF FLORIDA ) <br /> ) <br /> COUNTY OF Bjr u.ard ) <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 /> / <br /> /' / <br /> By: .„...........a.......... <br /> Title: President <br /> / <br /> The foregoing instrument was acknowledged before me this 6 day of <br /> January , 2017 , by Lawrence D. Maurer [name <br /> of person], as HVAC Company [type of authority], for <br /> Thermal Concepts, Inc. [name of party on behalf of whom instrument was <br /> executed]. <br /> AFFIX NOTARY STAMP HERE: , AO/ <br /> �,��`alzfrs <br /> AIDA BYRNE-PARRINELLO <br /> Notary Public— State of Florida <br /> Notary Public-State of Florida <br /> 1. ' Commission*GG 050824 �j/)!9 ?W?� �7 F/i/���- <br /> •;1 `�P:= My Comm.Expires Nov 28,2020 Print or Type Commissioned Name <br /> 'asi4;,d.•• Bonded throughNationalNotary-Assn. <br /> Personally Known x OR Produced Identification <br /> Type of Identification Produced <br /> DECEMBER 28,2010 7 of 10 <br />