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<br />SECTION 21 <br />ANTI-KICKBACK AFFIDAVIT <br /> <br /> <br />) <br />) <br />) <br /> <br />I, the undersigned, hereby duly sworn and deposed say that no portion of this sum <br />herein bid will be paid to any employees of the City of Sunny Isles Beach or its elected <br />officials as a commission, kickback, reward or gift, dire r' irectly by me or any <br />member of my firm or by an officer of the corporation. <br /> <br />By: <br /> <br /> <br />Title: <br /> <br /> <br />foregoing instrument was a~ aged before me this .~ day of <br />20-, b '-J ~. <br />[type of authority], for <br />[name of party on behalf of whom instrument <br /> <br />AFFIX NOTARY STAMP HERE: <br />~.~ Tina G Kwiatkowski <br /> <br />! ~ . My Commission DD17- <br /> <br />X~,..QI Expires January 24. <br /> <br /> <br />/ Print or Type Commissioned Name <br /> <br />Personally Known -L-. OR Produced Identification <br />Type of Identification Produced <br /> <br />END OF SECTION <br /> <br />PAGE 77 OF 78 <br />