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<br />'. <br />,I <br />I <br />II <br />I <br />I <br />I <br />I <br />I <br />II <br />'I <br />,I <br />'I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <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 />IV CL0 Y C>t4'~ <br />STATE OF FLORIDA ) <br />) <br />COUNTY OF fI.1rAn It l1../1a n ) <br /> <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 />By: <br /> <br />~ <br /> <br />-- <br /> <br />Title: rJ/'R r /oILM ~ <br />I - <br /> <br />The foregoing instrument was acknowledged before me this L day of <br />/IYl () -{r ~ A , 20 -.!L, by ;::fnrJb- 'pA..-L.) LLu ( YL..e [na me <br />of person], as p,,~ ) ; nI o~ [type of authority], for <br />])e.J J( ( Pr(Jffl JU.<.J a f.l f/1 {.~--t 11q{ ( / J, [name of party on behalf of whom instrument was <br />executed] . <br /> <br />AFFIX NOTARY STAMP HERE: <br /> <br /> <br />CAROLYN NEPO <br />NOTARY PUBLIC-STATE OF NEW YORK <br />No.01NE6117340 <br />Qualified In Nassau County <br />My Commission Expires _ I ~ / Lj . /; ~ <br />, <br /> <br />Notary Public - State of <br /> <br />(O MwL-~tU jUef/() <br />Print or Type Commissioned Name <br /> <br />Personally Known)( OR Produced Identification <br />Type of Identification' Produced <br /> <br />DECEMBER 28,2010 <br /> <br />70f7 <br />