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<br />SECTION 21 <br />ANTI-KICKBACK AFFIDAVIT <br /> <br />STATE OF FLORIDA ) <br />) <br />COUN1Y OF ) <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, directly or indirectly by me or any <br />member of my firm or by an officer of the corporation. <br /> <br /> <br />By: ~ .-a~~ <br /> <br />Title: PRSIDENT <br /> <br />The foregoing instru7nt was aCknOWledge~fore me this ') '] day of <br />~ '-.)~ , 2():) , by ~\ ":h~ ~\ C"-J- ~ <br />[name of person], as LUISA ALONSO [type of authority], for <br />[name of party on behalf of whom instrument <br /> <br />was executed]. ,'111111111/1 <br />'1\""" JOSE IIIIII/. <br />~ ....-.,~ ,,~ <br />AFFIX NOTA~~:s:r~~A~~~ <br />~ ~.' c:,'?,~\embfJ,. 9p'. <t-:; <br />$'0: 'b~..Y~ <br />=;!: ... "N-o~Cf>= <br />: ~ : ~ #00 .,. 5:? ~ : :: <br />~ -1)"~ ~ 08;>: C::) V): ~ <br />~ & ..~:?o.; ;]8$ ...::- <br />~~ ..~~c~/hlU ..elf ~ <br />~ C' '. no'erwrilers .... ~ <br />~~/ S}: ......... ~r ~ <br />'/111' -4 rE OF FI..O\l\ ,\,,~ <br />""'111 II"". A ~ 1) I' <br />Personally Known ltll. OR Produced Identification ~ ~ ,-' <br />Type of Identification Produced t==-,---, \) " ~ ~~ "")'2 ' ..Y 2-e \ k:J::.J ~ Q \( S' 1 (] <br /> <br />~ <br />/~ <br /> <br />~taJy--p~ic-::::; State of ~lor~d3' <br />~~~~ c--\~~~~ <br />Print or Type Commissioned Name <br /> <br />END OF SECTlON <br /> <br />PAGE 77 OF 78 <br />