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<br />IIVII <br />HOWARD R. MILLER <br />COMMUNICATIONS <br /> <br />ANTI-KICKBACK <br /> <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 /> <br />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA, <br />MIAMI-DADE COUNTY <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein <br />Bid will be paid to any employees of the City of Sunny Isles Beach or its elected officials as <br />a commission, kickback, reward or gift, directly or indirectly by me or any member of my <br />firm or by an officer of the corporation. <br /> <br />1Iuwtui 11. 71J dtt <br /> <br />By: <br /> <br />Title: President <br /> <br />The foregoing instrument was acknowledged before me this ~ day of <br /> <br />~/l~H C/h <br /> <br />, 2011, by <br /> <br />HoLO(] (a R. ~I/ tIle: r <br /> <br />[name <br /> <br />of person], as <br /> <br />[type of authority], for <br /> <br />[name of party on behalf of whom instrument was <br /> <br />executed] <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br />:~~~~'y:~i;~{[;~ YUjAINA GONZALEZ <br />:'(@";': 1,':'/ COMMISSION # DD816314 <br />-:.~...~.~: <br />--~>tQ;,fi.dr EXPIHES August 20.2012 <br />"'11\\\ <br />(407) ~Ob_( ..1!~ FIOLUa;'40IaryServlcecom <br /> <br />rd4# - (4 ~ <br />III II f2 OIL<. <br />No ublic - S e Of~ri <br />Y litO ina Gon?n lez... <br />Print Type Commissioned Name <br /> <br />Personally Known I OR Produced Identification <br />Type of Identification Produced <br /> <br />Page 43 of 43 Bd No 11-02-02 <br />