Laserfiche WebLink
SO"Ny IS(ES' <br />r <br />1F sy_. f' oR\O v <br />STATE OF FLORIDA ) <br />COUNTY OF Miami Dade) <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 />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 />Title: <br />The foregoing instrument was - _,acknowledged before me this I day of <br />20_�L, by tV1 -e y/ [name <br />of person], hs [type of authority], for <br />c [name of party on behalf of whom instrument was <br />executed]. <br />AFFIX NOTARY STAMP HERE: <br />EILEEN DAMASO <br />,,. MY COMMISSION k DD704322 <br />EXPIRES: November 11, 2011 <br />'t OF 7d o Fl. Notary Discount Assoc. Co. <br />1- e00a•HOTARY <br />Notary Public�Statte of Florida <br />Print or Type Commissioned Name <br />Personally Known OR Produced Identification <br />Type of Identification Produced <br />DECEMBER 28, 2010 7 of 7 <br />